PROGNOSIS FOR CHILDREN WITH SUPRATENTORIAL NEUROGLIAL TUMORS

Factor analysis of reliably identified histologic features in supraten torial glial tumors yielded five interpretable ''factors'':Spongy, Fib rillary, Proliferative, Jumbo, and Oligodendroglial. Quantitative scor es can be calculated for each factor in a tuner to summarize its heter ogeneity. The objective was to investigate whether factor scores are u seful for prognostic purposes. The sample consisted of 703 children wi th supratentorial neuroglial tumors with factor scores for each of the five factors. Data were based on the presence or absence of 26 reliab ly identified histologic features, plus clinical and survival informat ion. Multivariate proportional hazards models assessed each factor's c ontribution to survival for children who survived 1 month after operat ion (n = 609). Patient-specific clinical data were allowed in the mode ls. Increased likelihood of survival is associated with greater tumor removal, Inter decade of surgery, and high Spongy and high Oligodendro glial factor scores. Decreased likelihood of survival is associated wi th high Proliferative factor scores and radiation and/or chemotherapy treatment. Gender, age, location, and Jumbo and Fibrillary factor scor es did not provide additional prognostic information. Three reliable h istologic features, nondefining for any histologic factor, added progn ostic information: Rosenthal fibers and glomeruli are associated with improved prognosis; pleomorphic nuclei are associated with worse progn osis. A high Oligodendroglial factor score is associated with a worse prognosis for some classes of astrocytoma but with a better prognosis for oligodendroglial tumors. A high Proliferative score is associated with a worse prognosis for anaplastic astrocytomas, ependymomas, and u nclassifiable tumors. A high Spongy score is associated with a better prognosis for anaplastic astrocytomas but with a worse prognosis for p ilocytic astrocytomas. For giant cell astrocytomas, gangliogliomas, an d miscellaneous tumors, none of the factors is prognostic. Spongy, Oli godendroglial, and Proliferative factors Provide important prognostic information for children with supratentorial neuroglial tumors.