Surgery of cerebellar astrocytomas, ependymomas and medulloblastomas in children

A report is given on 118 children operated on for cerebellar astrocytoma, ependymoma or medulloblastoma in 1968-1982. During the first period (1968-1975) when the diagnosis was based on ventriculography and the operation performed later on the same day, the surgical mortality was 5%, 22%, and 16% respectively in these tumours. In the period since 1976, during which the diagnosis was based on CT and preoperative shunting was routine with the posterior fossa operation performed a week later and an operation microscope was available, no surgical mortality occurred. In patients with ependymoma or medulloblastoma the shunt was left in permanently; in patients with astrocytoma the shunt was removed if the patient tolerated its closure. The prognosis for astrocytoma was excellent. The 10-year survival rate was 97%. The five-year survival rate for medulloblastoma was 27% and the 10-year survival rate 13% which are less than the rates generally reported. For ependymoma patients the prognosis was poor whatever the therapy.