Prognostic limitations of the Daumas-Duport grading scheme in childhood supratentorial astroglial tumors

J Neuropathol Exp Neurol. 1998 Nov;57(11):1035-40. doi: 10.1097/00005072-199811000-00006.

Abstract

The Daumas-Duport grading scheme (DDGS) is a commonly used method for determining the grade of a tumor. It scores 4 histologic features and is used as a prognostic tool in adult astroglial tumors. This system of assigning children to prognostically homogeneous groups has not been evaluated. The Childhood Brain Tumor Consortium (CBTC) database includes 327 children with a CBTC assigned World Health Organization (WHO) diagnosis of supratentorial astroglial tumor and histologic features necessary for Daumas-Duport grading. We compared survival estimates for tumors within and between DDGS grades using a slightly broadened definition of endothelial prominence. The DDGS yielded only 3 histologic groups in children and only 2 prognostically differing groups. Subgroups within DDGS grades had significantly different survival distributions. The summing of 4 disparate histologic features in the DDGS is inadequate for the assessment of childhood supratentorial astroglial tumors. A classification system more fully summarizing the complete histologic content of tumors is most likely to provide diagnoses useful for clinical purposes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Astrocytoma / pathology*
  • Cerebellar Neoplasms / pathology*
  • Child
  • Child, Preschool
  • Endothelium / pathology
  • Glioblastoma / pathology*
  • Humans
  • Mitosis / physiology
  • Necrosis
  • Prognosis
  • Survival Analysis