Neurosurgical therapy of gangliogliomas in youngsters and adolescents: long-term follow-up of a single-institution sequence of 32 sufferers.
Acta Neurochir (Wien). 2018 Apr 22;:
Authors: Lundar T, Due-Tønnessen BJ, Fric R, Egge A, Krossnes B, Due-Tønnessen P, Stensvold E, Brandal P
OBJECT: The article of this research was to delineate long-term outcomes of the surgical therapy of pediatric tumors labeled as ganglioglioma or gangliocytoma.
METHODS: A cohort of consecutive sufferers 19 years or youthful who had undergone main resection of CNS tumors through the years 1980-2016 at a single establishment have been reviewed on this retrospective research of surgical morbidity, mortality, and educational achievement and/or work participation. Gross motor perform and actions of day by day residing have been scored utilizing the Barthel Index (BI).
RESULTS: Affected person data for 32 consecutive youngsters and adolescents who had undergone resection for a ganglioglioma have been included on this research. Of the 32 sufferers, 13 have been within the first decade on the first surgical procedure, whereas 19 have been within the second decade. The male/feminine ratio was 1.zero (16/16). No affected person was misplaced to follow-up. The tumor was localized to the supratentorial compartment in 26 sufferers, to the posterior fossa in 5 sufferers, and to the spinal wire in 1 affected person. Solely two of the tumors have been labeled as anaplastic. Of the 30 low-grade tumors, 2 have been labeled as gangliocytomas, 6 have been desmoplastic childish gangliogliomas, and 22 have been unusual gangliogliomas. The purpose of main surgical procedure was gross-total resection (GTR) and was achieved in 23 sufferers (71.9%). Altogether, 43 tumor resections have been carried out. Eight sufferers underwent a second resection from 1 to 10 years after main surgical procedure and three of those additionally had a 3rd resection from 2 to 24 years after preliminary surgical procedure. The rationale for additional resection was scientific (seizure management failure/recurrence of epilepsy or progressive neurological deficit) and/or residual tumor development/recurrence. There was no operative mortality on this sequence and all 32 sufferers are alive with follow-up durations from zero.5 to 36 years (median 14 years). Noticed 14-year survival is thus 100%. One out of two youngsters with main anaplastic tumor obtained native radiotherapy (proton) postoperatively. The opposite 31 sufferers didn’t have any form of non-surgical adjuvant remedy. Twenty-one out of 26 youngsters with supratentorial tumor had epilepsy as considered one of their presenting signs. Nineteen of those turned seizure-free after preliminary surgical procedure (18 of them after GTR), however three sufferers skilled recurrence of seizures inside some years. Purposeful consequence by way of ADL, education, and work participation was gratifying in most sufferers. 5 sufferers have persistent hydrocephalus (HC), handled with ventriculoperitoneal (VP) shunts.
CONCLUSION: Low-grade gangliogliomas (GGs) might be surgically handled with good long-term outcomes together with seizure and tumor management in addition to college and dealing participation.
PMID: 29680921 [PubMed – as supplied by publisher]