Staging and Grading

Staging is a way of describing a tumor, such as its size, where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Several types of childhood CNS tumors can spread through the spinal fluid that surrounds the brain and the spine. This information helps the doctor plan the treatment and determine the child’s prognosis (chance of recovery). In addition to staging, tumor grade strongly affects prognosis, with a low-grade tumor having a better prognosis than a higher-grade tumor. The grades of astrocytoma are:

Low-grade tumor. A low-grade tumor has cells that look similar to normal CNS cells under a microscope. The tumor usually does not grow quickly or spread to other parts of the CNS, although both rapid growth and spread can sometimes occur. Tumors may appear in more than one spot in the brain, especially when they are associated with neurofibromatosis (see Risk Factors). One of the more common low-grade tumors occurring almost only in children is called juvenile pilocytic astrocytoma, or JPA.

High-grade tumor. A high-grade tumor has cells that do not look similar to normal astrocytes. This type of tumor grows quickly and can spread extensively to other parts of the CNS.

Recurrent astrocytoma. Recurrent astrocytoma is a tumor that comes back after treatment. If it recurs, astrocytoma usually recurs near where it first started.