Skip to main content
Erschienen in: Journal of Neuro-Oncology 2/2019

30.03.2019 | Clinical Study

Diagnostic delay and morbidity of central nervous system tumors in children and young adults: a pediatric hospital experience

verfasst von: Vanisha Patel, Neil L. McNinch, Sarah Rush

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

Introduction

For children with central nervous system (CNS) tumors, survival rates remain significantly lower than other childhood malignancies with a substantial increase in disability of survivors. Given this, it is imperative that these children are identified at the earliest sign of symptom onset. Our institution aimed to identify diagnostic delays, morbidity and mortality, and specific barriers that may exist within our specific healthcare system that result in diagnostic delay.

Methods

A retrospective chart review was performed of newly diagnosed CNS tumors between January 1, 2008 and December 31, 2017.

Results

235 patient cases were reviewed, 34 (14.5%) of which had an associated tumor predisposition syndrome. Median age at the time of diagnosis was 9 years (range 1 day to 25 years), with median number of days from symptom onset to definitive diagnosis of 42 days (interquartile range 14–120 days). Delays longer than 60 days occurred in 95 (47.5%) patients. The 10 year relative survival rate for all tumors was 86.8%.

Conclusions

Our institution had a shorter interval from symptom onset to diagnosis than currently reported in the literature, as well as a decrease in associated morbidity. In addition, for those with longer delays, we were able to characterize the etiology and barriers leading to these delays. With these identified, we are able to utilize this knowledge to further improve education and awareness in community members and healthcare professionals to continue to improve the time to diagnosis in the future.
Literatur
1.
Zurück zum Zitat Hastings C, Torkildson JC, Agrawal AK, Children’s Hospital Medical Center (Oakland Calif.) (2012) Handbook of pediatric hematology and oncology: Children’s Hospital & Research Center Oakland. Wiley-Blackwell, ChichesterCrossRef Hastings C, Torkildson JC, Agrawal AK, Children’s Hospital Medical Center (Oakland Calif.) (2012) Handbook of pediatric hematology and oncology: Children’s Hospital & Research Center Oakland. Wiley-Blackwell, ChichesterCrossRef
3.
Zurück zum Zitat Curtin SC, Minino AM, Anderson RN (2016) Declines in cancer death rates among children and adolescents in the United States, 1999–2014. NCHS Data Brief 257:1–8 Curtin SC, Minino AM, Anderson RN (2016) Declines in cancer death rates among children and adolescents in the United States, 1999–2014. NCHS Data Brief 257:1–8
6.
Zurück zum Zitat Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ (2002) Latency between symptom onset and diagnosis of pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery 51:365–372 (Discussion 372–363) CrossRefPubMed Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ (2002) Latency between symptom onset and diagnosis of pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery 51:365–372 (Discussion 372–363) CrossRefPubMed
8.
12.
Zurück zum Zitat Rednam SP, Erez A, Druker H, Janeway KA, Kamihara J, Kohlmann WK, Nathanson KL, States LJ, Tomlinson GE, Villani A, Voss SD, Schiffman JD, Wasserman JD (2017) Von Hippel-Lindau and hereditary pheochromocytoma/paraganglioma syndromes: clinical features, genetics, and surveillance recommendations in childhood. Clin Cancer Res 23:e68–e75. https://doi.org/10.1158/1078-0432.CCR-17-0547 CrossRefPubMed Rednam SP, Erez A, Druker H, Janeway KA, Kamihara J, Kohlmann WK, Nathanson KL, States LJ, Tomlinson GE, Villani A, Voss SD, Schiffman JD, Wasserman JD (2017) Von Hippel-Lindau and hereditary pheochromocytoma/paraganglioma syndromes: clinical features, genetics, and surveillance recommendations in childhood. Clin Cancer Res 23:e68–e75. https://​doi.​org/​10.​1158/​1078-0432.​CCR-17-0547 CrossRefPubMed
22.
24.
Zurück zum Zitat Flores LE, Williams DL, Bell BA, O’Brien M, Ragab AH (1986) Delay in the diagnosis of pediatric brain tumors. Am J Dis Child 140:684–686PubMed Flores LE, Williams DL, Bell BA, O’Brien M, Ragab AH (1986) Delay in the diagnosis of pediatric brain tumors. Am J Dis Child 140:684–686PubMed
25.
Zurück zum Zitat Pollock BH, Krischer JP, Vietti TJ (1991) Interval between symptom onset and diagnosis of pediatric solid tumors. J Pediatr 119:725–732CrossRefPubMed Pollock BH, Krischer JP, Vietti TJ (1991) Interval between symptom onset and diagnosis of pediatric solid tumors. J Pediatr 119:725–732CrossRefPubMed
26.
Zurück zum Zitat Coven SL, Hollingsworth E, Stanek J, Walker D, Finlay JL (2016) EPI-03: establishing a baseline time-frame for symptom onset to definitive diagnosis of children with newly-diagnosed CNS tumors in Central Ohio. Neuro Oncol 63:S70–S71 Coven SL, Hollingsworth E, Stanek J, Walker D, Finlay JL (2016) EPI-03: establishing a baseline time-frame for symptom onset to definitive diagnosis of children with newly-diagnosed CNS tumors in Central Ohio. Neuro Oncol 63:S70–S71
27.
28.
Zurück zum Zitat Foreman NK, Faestel PM, Pearson J, Disabato J, Poole M, Wilkening G, Arenson EB, Greffe B, Thorne R (1999) Health status in 52 long-term survivors of pediatric brain tumors. J Neurooncol 41:47–53CrossRefPubMed Foreman NK, Faestel PM, Pearson J, Disabato J, Poole M, Wilkening G, Arenson EB, Greffe B, Thorne R (1999) Health status in 52 long-term survivors of pediatric brain tumors. J Neurooncol 41:47–53CrossRefPubMed
32.
Zurück zum Zitat Vuotto S, Krull K, Li C, et al (2019) Neurologic morbidities, emotional distress, and functional independence in adult survivors of childhood cancer treated with CNS-directed therapies: a report from the childhood cancer survivor study Vuotto S, Krull K, Li C, et al (2019) Neurologic morbidities, emotional distress, and functional independence in adult survivors of childhood cancer treated with CNS-directed therapies: a report from the childhood cancer survivor study
Metadaten
Titel
Diagnostic delay and morbidity of central nervous system tumors in children and young adults: a pediatric hospital experience
verfasst von
Vanisha Patel
Neil L. McNinch
Sarah Rush
Publikationsdatum
30.03.2019
Verlag
Springer US
Erschienen in
Journal of Neuro-Oncology / Ausgabe 2/2019
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-019-03160-9

Weitere Artikel der Ausgabe 2/2019

Journal of Neuro-Oncology 2/2019 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Nicht Creutzfeldt Jakob, sondern Abführtee-Vergiftung

29.05.2024 Hyponatriämie Nachrichten

Eine ältere Frau trinkt regelmäßig Sennesblättertee gegen ihre Verstopfung. Der scheint plötzlich gut zu wirken. Auf Durchfall und Erbrechen folgt allerdings eine Hyponatriämie. Nach deren Korrektur kommt es plötzlich zu progredienten Kognitions- und Verhaltensstörungen.

Schutz der Synapsen bei Alzheimer

29.05.2024 Morbus Alzheimer Nachrichten

Mit einem Neurotrophin-Rezeptor-Modulator lässt sich möglicherweise eine bestehende Alzheimerdemenz etwas abschwächen: Erste Phase-2-Daten deuten auf einen verbesserten Synapsenschutz.

Sozialer Aufstieg verringert Demenzgefahr

24.05.2024 Demenz Nachrichten

Ein hohes soziales Niveau ist mit die beste Versicherung gegen eine Demenz. Noch geringer ist das Demenzrisiko für Menschen, die sozial aufsteigen: Sie gewinnen fast zwei demenzfreie Lebensjahre. Umgekehrt steigt die Demenzgefahr beim sozialen Abstieg.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.