Long-term neuropsychologic outcome in children diagnosed with a low-grade astrocytoma

Central nervous system (CNS) tumors in children have a relatively high frequency. They are the second most common form of cancer in childhood only exceeded by acute lymphoblastic leukemia (ALL). However, prognosis is more severe and at present more children die because of CNS tumor than of ALL. The incidence of CNS tumors is estimated 3.5 per 100,000 in children below 15 years of age.1 Boys appear to be at greater risk than girls (1.1:1) and this ratio is even higher in primitive neuro-ectodermal tumor (PNET), plexus papilloma, and germinoma (2:1).1 The most frequently occurring histological tumor type is astrocytoma (40-50%) followed by medulloblastoma (15-20%), ependymoma (8-13%), and craniopharyngiomas (7-10%) as shown in Table 1.2 Astrocytomas are classified according to increasing malignancy grade as pilocytic, fibrillary, anaplastic astrocytoma, and glioblastoma. The most common variant in children is the pilocytic astrocytoma.

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