Prognosis and survival for childhood brain and spinal cord tumours

A prognosis is the doctor's best estimate of how cancer will affect your child and how it will respond to treatment. Survival is the percentage of children with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many things.

The doctor will look at certain aspects of the cancer as well as characteristics of the child (such as their age). These are called prognostic factors. The doctor will also look at predictive factors, which influence how a cancer will respond to a certain treatment and how likely it is that the cancer will come back (recur) after treatment.

Prognostic and predictive factors are often discussed together. They both play a part in deciding on a prognosis and a treatment plan just for your child. Only a doctor familiar with your child's medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis and chances of survival.

The following are prognostic and predictive factors for childhood brain and spinal cord tumours.

The type of brain or spinal cord tumour is an important prognostic factor. Some tumour types have a more favourable prognosis than others.

Low-grade, slow-growing tumours usually have a more favourable prognosis than high-grade, fast-growing tumours.

The location of the tumour is an important prognostic factor because it determines if the tumour can be completely removed with surgery. Easily accessible tumours have a more favourable prognosis. Tumours in the cerebrum and cerebellum tend to have a better outcome than those in the brain stem, ventricles or midbrain. But other factors, such as the grade of the tumour, will affect the prognosis of tumours in the cerebrum and cerebellum.

Tumours that can be completely removed with surgery (are resectable) have a more favourable prognosis than tumours that can’t be removed with surgery (are unresectable).

Certain genetic conditions or changes may affect your child’s prognosis, depending on the type of brain or spinal cord tumour.

Children with neurofibromastosis type 1 (NF1) diagnosed with some types of brain or spinal cord tumours have a better prognosis.

Children older than 3 years of age tend to have a more favourable prognosis than children under the age of 3. This may be because children older than 3 can be given radiation. Many types of childhood brain and spinal cord tumours are sensitive to the effects of radiation, so if the child is old enough to receive radiation, it could improve the prognosis. In addition, the types of tumours that often develop in children younger than 3 years old may be more aggressive.

For some types of tumours, such as brain stem glioma, children younger than 3 may have a better prognosis.

If a tumour spreads to other areas of the central nervous system (CNS), the prognosis is less favourable.