To determine the relationship between clinical presentation, radiographic features, pathology, and treatment on overall survival of newly diagnosed pediatric primary
spinal cord tumors (PSCT). Retrospective analysis of all previously healthy children with newly diagnosed PSCT at a single institution from 1995 to present was performed. Twenty-five pediatric patients (15 boys, average 7.9 years) were diagnosed with PSCT. Presenting symptoms ranged from 0.25 to 60 months (average 7.8 months). Symptom duration was significantly shorter for high grade
tumors (average 1.65 months) than low grade
tumors (average 11.2 months) (P = 0.05). MRI revealed
tumor (8 cervical, 17 thoracic, 7 lumbar, 7 sacral) volumes of 98-94,080 mm(3) (average 19,474 mm(3)). Homogeneous
gadolinium enhancement on MRI correlated with lower grade pathology (P = 0.003). There was no correlation between
tumor grade and volume (P = 0.63) or
edema (P = 0.36) by MRI analysis. Median survival was 53 months and was dependent on
tumor grade (P = 0.05) and gross total resection (P = 0.01) but not on gender (P = 0.49), age of presentation (P = 0.82), duration of presenting symptoms (P = 0.33), or adjuvant
therapies (P = 0.17). Stratified Kaplan-Meier analysis confirmed the association between degree of resection and survival after controlling for
tumor grade (P = 0.01). MRI homogeneous
gadolinium enhancement patterns may be helpful in distinguishing low grade from high grade spinal cord
malignancies. While
tumor grade and gross total resection rather than duration of symptoms correlated with survival in our series, greater than one-third of patients had reported symptoms greater than 6 months duration prior to diagnosis.