Brain and Spinal Cord Tumors in Children

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Early Detection, Diagnosis, and Staging TOPICS

How are brain and spinal cord tumors in children staged?

The stage of a cancer is a measure of how far it has spread. The extent of spread is based on the results of imaging tests (see “How are brain and spinal cord tumors in children diagnosed?”) and any other tests that have been done.

For most types of cancer, the stage is one of the most important factors in selecting treatment options and in determining the outlook (prognosis). But tumors of the brain and spinal cord differ in some important ways from cancers in other parts of the body. One of the main reasons other cancers are dangerous is that they can spread throughout the body. Tumors starting in the brain or spinal cord can spread to other parts of the central nervous system, but they almost never spread to other organs. These tumors are dangerous because when they grow, it can interfere with essential functions of the brain.

Because most tumors in the brain or spinal cord do not usually spread, they are not formally staged. Some of the most important factors that determine your child’s prognosis include:

  • The type of tumor (such as astrocytoma, ependymoma, etc.)
  • The grade of the tumor (how quickly the tumor is likely to grow, based on how the cells look under a microscope)
  • The location and size of the tumor
  • How much of the tumor can be removed by surgery (if it can be done)
  • Your child’s age
  • Your child’s functional level (whether the tumor is affecting normal brain functions and everyday activities)
  • Whether or not the tumor has spread through the cerebrospinal fluid (CSF) to other parts of the brain or spinal cord
  • Whether or not tumor cells have spread beyond the central nervous system

Medulloblastoma risk groups

A staging system is a standard way for the cancer care team to describe the extent of tumor spread. Formal staging systems have been proposed for some childhood brain tumors.

For example, many clinical trials for treating medulloblastoma use a system that places children into either standard-risk or high-risk groups. Children are placed in the high-risk group if any of these apply:

  • The child is younger than 3
  • A lot of the tumor can’t be removed during surgery
  • Tumor cells are in the CSF or have spread to other parts of the brain or elsewhere

Doctors are still refining this system to make it as accurate as possible.

Recent research has shown that medulloblastomas can be divided into 4 types, based on the major gene changes found in the cancer cells. Each type of medulloblastoma has a different outlook, so doctors may be able to use this to better tailor the treatment each child gets (see “What’s new in research and treatment for brain tumors in children?”).


Last Medical Review: 08/12/2014
Last Revised: 08/24/2014