Brain tumors in children under 3 years of age differ in clinical presentati
on and pathological behavior from those in older patients. In this study, w
e reviewed data from 39 children (24 males and 15 females) under 3 years of
age who were treated for intracranial brain tumors since the introduction
of magnetic resonance imaging. The purpose was to assess correlations betwe
en clinicoradiological and treatment-related factors, and their impact on p
rognosis. The following factors were analyzed: sex, age, duration of sympto
ms, intracranial hypertension on admission, tumor location, surgical remova
l and histology. Associations between these factors and correlations with p
rognosis were determined using bivariate analyses (chi(2) test) and Kaplan-
Meier survival curves. Collins' concept of a period of risk recurrence was
tested. Mean follow-up was 41 months (range 0-136). In March 1998, 20 child
ren were still alive (51.2%) with a mean survival time of 65 months (range
2-136). The incidence of supratentorial tumors was significantly higher in
children less than 1 year old (p = 0.027). Lateral tumors were 9/10 (90%) s
upratentorial versus only 7/26 (27%) midline tumors (p = 0.001). Outcome (d
ead or alive) was significantly better (p = 0.037) for low-grade astrocytom
as (9/12 = 75% survival) when compared to ependymomas (2/6 = 33%) and primi
tive neuroectodermal tumors (3/12 = 25%). Total tumor removal was achieved
in 20 cases and was associated with a better outcome (65 vs. 33% survival;
p = 0.049). Survival analysis confirmed a worse prognosis for children with
ependymomas and primitive neuroectodermal tumors (p = 0.011) and revealed
a worse survival for children with intracranial hypertension on admission (
p = 0.047). Total tumor removal was associated with a longer survival, alth
ough not significantly (p = 0.077). Finally, we found no exceptions to Coll
ins' law.