Survival and functional outcomes in paediatric thalamic and thalamopeduncular low grade gliomas.

Autor: Beneš V 3rd; Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, Prague, Czech Republic. vladimir.benes@fnmotol.cz., Zápotocký M; Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Libý P; Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, Prague, Czech Republic., Táborský J; Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, Prague, Czech Republic., Blažková J Jr; Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, Prague, Czech Republic., Blažková J Sr; Department of Anaesthesiology and Intensive Care Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Sumerauer D; Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Mišove A; Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Perníková I; Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Kynčl M; Department of Radiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Krsková L; Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Koblížek M; Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Zámečník J; Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Bradáč O; Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, Prague, Czech Republic.; Department of Neurosurgery and Neurooncology, First Medical Faculty, Charles University and Military University Hospital, Prague, Czech Republic., Tichý M; Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, Prague, Czech Republic.
Jazyk: angličtina
Zdroj: Acta neurochirurgica [Acta Neurochir (Wien)] 2022 Jun; Vol. 164 (6), pp. 1459-1472. Date of Electronic Publication: 2022 Jan 19.
DOI: 10.1007/s00701-021-05106-5
Abstrakt: Background: Childhood thalamopeduncular gliomas arise at the interface of the thalamus and cerebral peduncle. The optimal treatment is total resection but not at the cost of neurological function. We present long-term clinical and oncological outcomes of maximal safe resection.
Methods: Retrospective review of prospectively collected data: demography, symptomatology, imaging, extent of resection, surgical complications, histology, functional and oncological outcome.
Results: During 16-year period (2005-2020), 21 patients were treated at our institution. These were 13 girls and 8 boys (mean age 7.6 years). Presentation included progressive hemiparesis in 9 patients, raised intracranial pressure in 9 patients and cerebellar symptomatology in 3 patients. The tumour was confined to the thalamus in 6 cases. Extent of resection was judged on postoperative imaging as total (6), near-total (6) and less extensive (9). Surgical complications included progression of baseline neurological status in 6 patients, and 5 of these gradually improved to preoperative status. All tumours were classified as low-grade gliomas. Disease progression was observed in 9 patients (median progression-free survival 7.3 years). At last follow-up (median 6.1 years), all patients were alive, median Lansky score of 90. Seven patients were without evidence of disease, 6 had stable disease, 7 stable following progression and 1 had progressive disease managed expectantly.
Conclusion: Paediatric patients with low-grade thalamopeduncular gliomas have excellent long-term functional and oncological outcomes when gross total resection is not achievable. Surgery should aim at total resection; however, neurological function should not be endangered due to excellent chance for long-term survival.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)
Databáze: MEDLINE
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