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Background Adult survivors of childhood central nervous system (CNS) malignancies are at high risk for long-term morbidity and late mortality. However, patterns of late mortality, the long-term risks of subsequent neoplasms and debilitating medical conditions, and sociodemographic outcomes have not been comprehensively characterized for individual diagnostic and treatment groups. Methods We collected information on treatment, mortality, chronic medical conditions, and neurocognitive functioning of adult 5-year survivors of CNS malignancies diagnosed between 1970 and 1986 within the Childhood Cancer Survivor Study. Using competing risk framework, we calculated cumulative mortality according to cause of death and cumulative incidence of subsequent neoplasms according to exposure and dose of cranial radiation therapy (RT). Neurocognitive impairment and socioeconomic outcomes were assessed with respect to dose of CNS radiotherapy to specific brain regions. Cumulative incidence of chronic medical conditions was compared between survivors and siblings using Cox regression models. All tests of statistical significance were two-sided. Results Among all eligible 5-year survivors (n = 2821), cumulative late mortality at 30 years was 25.8% (95% confidence interval [CI = 23.4% to 28.3%), due primarily to recurrence and/or progression of primary disease. Patients who received cranial RT of 50 Gy or more (n = 813) had a cumulative incidence of a subsequent neoplasm within the CNS of 7.1% (95% CI = 4.5% to 9.6%) at 25 years from diagnosis compared with 1.0% (95% CI = 0% to 2.3%) for patients who had no RT. Survivors had higher risk than siblings of developing new endocrine, neurological, or sensory complications 5 or more years after diagnosis. Neurocognitive impairment was high and proportional to radiation dose for specific tumor types. There was a dose-dependent association between RT to the frontal and/or temporal lobes and lower rates of employment, and marriage. Conclusions Survivors of childhood CNS malignancies are at high risk for late mortality and for developing subsequent neoplasms and chronic medical conditions. Care providers should be informed of these risks so they can provide risk-directed care and develop screening guidelines.

Objectives: To compare the squash smear technique with the histopathological examination in the diagnosis of Central Nervous System (CNS) gliomas and to assess the utility of the squash smear technique for the rapid diagnosis in the neurosurgical biopsies for real time intraoperative consultation. Methodology: This was a prospective study conducted in the Department of Neuropathology of Sir J.J. hospital for a period of 6 months. Fifty cases of radiologically suspected CNS gliomas were sent for intraoperative smear cytology and subjected to both histopathological examination and squash smear cytology. The two techniques were then compared for their ability to diagnose as well as grade the tumor. Appropriate statistical analysis methods were then applied to the findings. Results: Smear cytology and histopathology diagnoses were compared. The following values were obtained: accuracy of 88%, sensitivity of 91.6%, specificity and positive predictive value of 100%. Conclusion: Intraoperative cytological diagnosis is fairly accurate, safe, simple, reliable and cost effective tool for rapid diagnosis of CNS gliomas and is of great value in intraoperative consultation of CNS tumors. Keywords: Squash Cytology | CNS tumors and Gliomas, Introduction The intraoperative cytology preparation was first introduced by Eisenhardt and Cushing in early 1930 and by Badt in 1937. (1,2) This technique was further championed and documented by Russell [...]