• Stéphanie Puget, Nathalie Boddaert, Anne-Sophie Veillard, Mathew Garnett, Catherine Miquel, Felipe Andreiuolo, Christian Sainte-Rose, Thomas Roujeau, Federico DiRocco, Marie Bourgeois, Michel Zerah, François Doz, Jacques Grill, and Pascale Varlet.
• Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes, Paris, France. stephanie.puget@nck.aphp.fr
• Neurosurgery. 2011 Jul 1;69(1):215-24.

BackgroundThe diagnostic accuracy and reproducibility for glioma histological diagnosis are suboptimal.ObjectiveTo characterize radiological and histological features in pediatric malignant gliomas and to determine whether they had an impact on survival.MethodsWe retrospectively reviewed a series of 96 pediatric malignant gliomas. All histological samples were blindly and independently reviewed and classified according to World Health Organization 2007 and Sainte-Anne classifications. Radiological features were reviewed independently. Statistical analyses were performed to investigate the relationship between clinical, radiological, and histological features and survival.ResultsCohort median age was 7.8 years; median follow-up was 4.8 years. Tumors involved cerebral hemispheres or basal ganglia in 82% of cases and brainstem in the remaining 18%. After histopathological review, low-grade gliomas and nonglial tumors were excluded (n = 27). The World Health Organization classification was not able to demonstrate differences between groups and patients survival. The Sainte-Anne classification identified a 3-year survival rate difference between the histological subgroups (oligodendroglioma A, oligodendroglioma B, malignant glioneuronal tumors, and glioblastomas; P = .02). The malignant glioneuronal tumor was the only glioma subtype with specific radiological features. Tumor location was significantly associated with 3-year survival rate (P = .005). Meningeal attachment was the only radiological criteria associated with longer survival (P = .02).ConclusionThe Sainte-Anne classification was better able to distinguish pediatric malignant gliomas in terms of survival compared with the World Health Organization classification. In this series, neither of these 2 histological classifications provided a prognostic stratification of the patients.

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