Prognostic significance of DNA ploidy in childhood astrocytomas

The ability to divide subsets of children with astrocytoma into prognostic groups is limited because only a few clinical and pathologic variables are available. This study evaluated DNA ploidy as a potential prognostic factor in 30 children with diagnosed gliomas and examined the correlation of flow cytometric analysis to other parameters such as sex, age at diagnosis, his tologic grading, localization of tumor, and completeness of surgical resect ion. Seventeen children, with low-grade glioma and 13 with high-grade gliom a were retrospectively reviewed; mean age of the patients was 8.2 years, an d mean follow-up of the population was 7.6 years. The tumor was localized t o the cerebrum in 19 patients, the cerebellum in 7 patients, the brain stem in 3 patients, and the spine in I patient. Fourteen patients underwent com plete excision and 16 patients underwent partial excision. DNA diploidy was demonstrated in 21 patients and aneuploidy in 9 patients. Twenty children had no evidence of disease and 10 died of disease. Of the patients with dip loid tumors, 81 % survived, compared to only 33% survival among patients wi th aneuploid tumors (p < .011). By Cox regression analysis with age, gender , type of excision, grade, location of tumor, and ploidy as independent var iables, ploidy was a statistically significant predictor of survival (p = . 043). This investigation provides further evidence that flow cytometry may have prognostic value in children with gliomas. Thus, a larger number of tu mors can be studied to extend and validate these observations..