A population-based study on pediatric spinal cord tumors, with emphasis on intramedullary ones

Abstract

Purpose: Pediatric spinal cord tumors are rare accounting for 4-6% of all primary CNS tumors in this age group. Collecting large number of cases has always been difficult due to their scarcity. SEER database provides a source on various tumors. Methods: We performed analysis on tumors of the spinal cord in patients between births to 20 years of age using the SEER data available for the period 1973-2005. Analysis of the incidence rate, the frequency of the most common types, the age, gender, treatment modality including radiotherapy and surgery is provided. In addition; the overall survival and the median survival has been analyzed for each tumor type and comparison between various types is performed. Results: There were 483 cases of spinal cord tumors with available data, representing 4.7% of all pediatric central nervous system tumors diagnosed over the same period. They predominated in males and in whites. The median age for diagnosis was 10 years, with two age peaks noted; in <3 years old and in adolescents 12 to 17 years old. Of intramedullary tumors astrocytoma was the most common histology followed by ependymoma. Low grade tumors predominated. Of all variables examined; histologic type, grade, gross total resection and not receiving radiotherapy showed significant association with outcome. Conclusions: Low-grade astrocytoma is the most common intramedullary tumor in first 2 decades of life, while ependymoma is mostly seen in the second decade of life. Assigning the appropriate histologic type and grade is important in determining the outcome of the patients.