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Aftahy, A.K.* ; Barz, M.* ; Krauss, P.* ; Liesche, F.* ; Wiestler, B.* ; Combs, S.E. ; Straube, C.* ; Meyer, B.* ; Gempt, J.*

Intraventricular neuroepithelial tumors: Surgical outcome, technical considerations and review of literature.

BMC Cancer 20:1060 (2020)
Publ. Version/Full Text DOI
Open Access Gold
Creative Commons Lizenzvertrag
Background: Intraventricular neuroepithelial tumors (IVT) are rare lesions and comprise different pathological entities such as ependymomas, subependymomas and central neurocytomas. The treatment of choice is neurosurgical resection, which can be challenging due to their intraventricular location. Different surgical approaches to the ventricles are described. Here we report a large series of IVTs, its postoperative outcome at a single tertiary center and discuss suitable surgical approaches. Methods: We performed a retrospective chart review at a single tertiary neurosurgical center between 03/2009–05/2019. We included patients that underwent resection of an IVT emphasizing on surgical approach, extent of resection, clinical outcome and postoperative complications. Results: Forty five IVTs were resected from 03/2009 to 05/2019, 13 ependymomas, 21 subependymomas, 10 central neurocytomas and one glioependymal cyst. Median age was 52,5 years with 55.6% (25) male and 44.4% (20) female patients. Gross total resection was achieved in 93.3% (42/45). 84.6% (11/13) of ependymomas, 100% (12/21) of subependymomas, 90% (9/10) of central neurocytomas and one glioependymal cyst were completely removed. Postoperative rate of new neurological deficits was 26.6% (12/45). Postoperative new permanent cranial nerve deficits occurred in one case with 4th ventricle subependymoma and one in 4th ventricle ependymoma. Postoperative KPSS was 90% (IR 80–100). 31.1% of the patients improved in KPSS, 48.9% remained unchanged and 20% declined. Postoperative adverse events rate was 20.0%. Surgery-related mortality was 2.2%. The rate of shunt/cisternostomy-dependent hydrocephalus was 13.3% (6/45). 15.4% of resected ependymomas underwent adjuvant radiotherapy. Mean follow-up was 26,9 (±30.1) months. Conclusion: Our surgical findings emphasize satisfactory complete resection throughout all entities. Surgical treatment can remain feasible, if institutional experience is given. Satisfying long-term survival and cure is possible by complete removal. Gross total resection should always be performed under function-remaining aspects due to mostly benign or slow growing nature of IVTs. Further data is needed to evaluate standard of care and alternative therapy options in rare cases of tumor recurrence or in case of patient collective not suitable for operative resection.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Central Neurocytoma ; Ependymoma ; Extent Of Resection ; Intraventricular Tumor ; Neuroepithelial ; Neurosurgery ; Subependymoma ; Surgical Technique; Central-nervous-system; Telovelar Approach; Radiation-therapy; Stereotactic Radiosurgery; Symptomatic Subependymoma; Central Neurocytoma; Clinical-features; Grade-ii; 4th-ventricle; Supratentorial
ISSN (print) / ISBN 1471-2407
e-ISSN 1471-2407
Journal BMC Cancer
Quellenangaben Volume: 20, Issue: 1, Pages: , Article Number: 1060 Supplement: ,
Publisher BioMed Central
Publishing Place Campus, 4 Crinan St, London N1 9xw, England
Reviewing status Peer reviewed
Grants Projekt DEAL