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- Title
Outcomes with respect to extent of surgical resection for pediatric atypical teratoid rhabdoid tumors.
- Authors
Richards, Alexandra; Ved, Ronak; Murphy, Christopher; Hennigan, Dawn; Kilday, John-Paul; Kamaly-Asl, Ian; Mallucci, Conor; Bhatti, Imran; Patel, Chirag; Leach, Paul
- Abstract
Purpose: To evaluate overall survival for atypical teratoid rhabdoid tumors (ATRTs) in relation to extent of surgical resection. Methods: The neurosurgical tumor databases from three UK Pediatric centers (University Hospital of Wales, Alder Hey and Royal Manchester Children's Hospital) were analyzed. Patients with a diagnosis of ATRT were identified between 2000 and 2018. Data was collected regarding demographics, extent of resection, complications, and overall survival. Results: Twenty-four patients diagnosed with ATRT underwent thirty-eight operations. The age range was 20 days to 147 months (median 17.5 months). The most common location for the tumor was the posterior fossa (nine patients; 38%). Six patients (25%) underwent a complete total resection (CTR), seven (29%) underwent a near total resection (NTR), eight (33.3%) underwent a subtotal resection (STR), and three patients (12.5%) had biopsy only. Two-thirds of patients who underwent a CTR are still alive, as of March 2019, compared to 29% in the NTR and 12.5% in the STR groups. Out of the thirty-eight operations, there were a total of twenty-two complications, of which the most common was pseudomeningocele (27%). The extent of surgical resection (p = 0.021), age at surgery (p = 0.00015), and the presence of metastases at diagnosis (0.015) significantly affected overall survival. Conclusions: Although these patients are a highly vulnerable group, maximal resection is recommended where possible, for the best chance of long-term survival. However, near total resections are likely beneficial when compared with subtotal resections and biopsy alone. Maximal surgical resection should be combined with adjuvant therapies for the best long-term outcomes.
- Subjects
WALES; SURGICAL excision; TERATOMA; CHILDREN'S hospitals; INFRATENTORIAL brain tumors; UNIVERSITY hospitals
- Publication
Child's Nervous System, 2020, Vol 36, Issue 4, p713
- ISSN
0256-7040
- Publication type
Article
- DOI
10.1007/s00381-019-04478-5