LG-49: LOW GRADE GLIOMA (LGG) OF THE SPINAL CORD. SPECIFIC LOCATION NEEDS SPECIFIC TREATMENT

INTRODUCTION: Spinal cord LGG constitute approximately 3,5% of all LGG locations. No specific therapeutic guidelines are available for this specific LGG site. AIM: Analysis of childhood spinal cord LGG. METHODOLOGY: 28 patients treated between 2004-2015 were analyzed for: sex, age, symptoms, pathology, treatment and outcome. RESULTS: There were 20 boys and 8 girls, aged 10 months-17 years, median 4.5 years. Paresis,scoliosis and pain were the most common symptoms. Pathology revealed Pilocytic astrocytoma in 21, Pilomyxoid astrocytoma in 4, LGG NOS in 3 patients. In 5 patients total or subtotal resections was performed, in 17 partial resection, in 6 biopsy were performed. In 13 pts neurological improvement was observed, in 7 – deterioration, the rest remained stable. 13 patients had no further treatment. 15 received chemotherapy: 7 following surgical treatment, 8 at tumor progression. 12 patients started with LGG protocol, 3 with VLB. In 10 patients stabilization, in 5 minimal tumor regression were observed. All patients are alive with median follow-up 3 years 8 months. 5 yr and 10 yr EFS are 52,1%, 27,7, respectively. 10 patients are walking without paresis, 9 with paresis, 2 have scoliosis, 6 pts use wheelchair, 1 is paralized. CONCLUSIONS: Spinal cord LGG have a good prognosis. Surgery improves neurological outcome, but radical resections are not mandated to achieve that. Some patients with tumor residual may not require further treatment, but at tumor progression chemotherapy is the treatment of choice. Quality of life should be the priority in choosing surgical strategy.