ORIGINAL PAPER Low-grade gliomas in children: single institutional experience in 198 cases Magda Garzón 1 & Gemma García-Fructuoso 1 & Mariona Suñol 2 & Jaume Mora 3 & Ofelia Cruz 3 Received: 16 November 2014 /Accepted: 22 June 2015 # Springer-Verlag Berlin Heidelberg 2015 Abstract Introduction In pediatric population (0–18 years), low-grade gliomas (PLGG) are the most frequent brain tumors and ma- jority are amenable for surgical removal. Patients and methods A retrospective review of 198 children diagnosed with PLGG between 1980 and 2010 at HSJD was carried out. Several variables were studied to find prognostic factors related to the outcomes (progression-free survival (PFS) and overall survival (OS)). Results Median age at onset was 88.8 months (3.1 to 214.5 months, SD 53). Surgery was performed in 175 patients (88.4 %), achieving gross total resection (GTR) in 77 (44 %), subtotal resection (STR) in 87 (49.7 %), and 11 (6.3 %) biop- sies. Pathological review classified 84 tumors as WHO grade I (48 %) and 89 as grade II (50.8 %). Adjuvant therapy (AT) was given to 75 patients (37.9 %), radiotherapy in 24 (12.1 %), chemotherapy in 33 (16.7 %), and combined in 18 (9.1 %). Sixteen patients (8.1 %) died, 89 (43.4 %) are alive with no evidence of disease, and 93 (47 %) alive with disease, median follow-up 65.2 months. Outcome is significantly cor- related with age (p = 0001, worse OS for patients younger than 12 months) and extent of tumor resection (p < 0001). OS for GTR/STR/biopsy was >200, 154.3, and 101.9 months, respectively. Patients treated with AT presented worse OS/ PFS (p < 0.001) than those not treated. Histology was non significantly related to outcomes. Conclusion In our series of PLGG, the best prognostic markers are tumor location (cerebellar) and the extent of tu- mor resection (GTR). Infants and patients who require adju- vant therapy because of tumor progression or recurrence have worse outcome. Keywords Pediatric brain tumors . Pediatric low-grade glioma . Outcome studies . Pediatric neurosurgery . Chemotherapy . Radiotherapy Introduction Pediatric low-grade gliomas (PLGG) constitute a wide variety of tumors with diverse histology for which the mainstay of treatment is surgical excision. The feasibility to achieve a gross total resection (GTR) has been widely reported as the most relevant prognostic factor. Different rates of progression in residual tumors or recurrence after GTR have been reported [9, 15, 32, 33, 42, 45]. Besides location and extent of tumor resection, other clinical variables, radiological characteristics (such as tumor extent and brain infiltration), and histologic and biological features have been used in the past in an at- tempt to predict long-term outcomes. Our aim retrospectively reviewing this large cohort of children with PLGG was to Electronic supplementary material The online version of this article (doi:10.1007/s00381-015-2800-9) contains supplementary material, which is available to authorized users. * Magda Garzón dendrita07@gmail.com * Ofelia Cruz ocruz@hsjdbcn.org 1 Department of Neurosurgery, Hospital Sant Joan de Déu, University of Barcelona, Passeig St. Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain 2 Department of Pathology, Hospital Sant Joan de Déu, University of Barcelona, Passeig St. Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain 3 Department of Oncology, Hospital Sant Joan de Déu, University of Barcelona, Passeig St. Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain Childs Nerv Syst DOI 10.1007/s00381-015-2800-9