The prognosis varies significantly depending on the tumor type: diffuse infiltrating vs focal
Patients with diffuse infiltrating brain stem gliomas have a very poor outcome
- 5-20% overall survival at 2 years.
- Median time to progression is between 5 and 9 months
- Median overall survival ranges from 8 to 11 months.
Intratumoral hemorrhage occurs in up to 20% of patients with diffuse brain stem gliomas and may complicate clinical management.
Patients with focal brain stem glioma have ~90% overall survival at 2 years.
- Certain tumor locations are associated with a better prognosis. Midbrain tumors in children have a median survival of 50 months; these are also more likely to be focal gliomas.
- Race and gender of patients, hydrocephalus and tumor necrosis have not been found to affect survival.
- Brain stem gliomas in patients with NF-1 are generally indolent and may not require treatment for years.
Morbidity is highly dependent on the location of the lesion and its compression of the surrounding structures. As brain stem structures are responsible for the regulation of basic body functions, their damage can have a substantial neurological effects.
Comparison of prognostic factors:
Poor Prognostic Factors |
Favorable Prognostic Factors |
Short clinical history with multiple brain stem signs |
Longer duration of symptoms (>12 months) |
Diffuse involvement of the pons |
Exophytic tumor with cystic components Focal cervicomedullary and tectal tumors Calcification on CT scan |
| High-grade tumor pathology | Low-grade tumor pathology |
| Very young age (<2 years) | Neurofibromatosis type 1 |
