Brainstem gangliogliomas: prognostic factors, surgical indications and functional outcomes

To explore the prognostic factors and discuss the surgical indications of brainstem gangliogliomas. Twenty-one patients with brainstem ganglioglioma were surgically treated at our hospital between 2006 and 2014. The clinical, radiological, operative, and pathological findings of these patients were...

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Bibliographic Details
Published in:Journal of neuro-oncology 2016-07, Vol.128 (3), p.445-453
Main Authors: Pan, Chang-cun, Chen, Xin, Xu, Cheng, Wu, Wen-hao, Zhang, Peng, Wang, Yu, Wu, Tao, Tang, Jie, Xiao, Xin-ru, Wu, Zhen, Zhang, Jun-ting, Zhang, Li-wei
Format: Article
Language:English
Subjects:
Adolescent
Adult
Brain Stem - diagnostic imaging
Brain Stem - pathology
Brain Stem - surgery
Brain Stem Neoplasms - diagnosis
Brain Stem Neoplasms - genetics
Brain Stem Neoplasms - mortality
Brain Stem Neoplasms - surgery
Child
Child, Preschool
Clinical Study
Female
Follow-Up Studies
Ganglioglioma - diagnosis
Ganglioglioma - genetics
Ganglioglioma - mortality
Ganglioglioma - surgery
Humans
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Mutation
Neoplasm Recurrence, Local
Neurology
Oncology
Postoperative Complications - mortality
Prognosis
Proportional Hazards Models
Proto-Oncogene Proteins B-raf - genetics
Retrospective Studies
Survival Analysis
Young Adult
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Summary:To explore the prognostic factors and discuss the surgical indications of brainstem gangliogliomas. Twenty-one patients with brainstem ganglioglioma were surgically treated at our hospital between 2006 and 2014. The clinical, radiological, operative, and pathological findings of these patients were retrospectively reviewed. The 3-years overall survival and event-free survival (EFS) rates were 90.5 % and 68.4 %, respectively. Four patients (4/18, 22 %) experienced a recurrence with a mean recurrence-free survival of 5.5 months and a mean follow-up of 37 months. Three patients died of surgery-related complications. Three growth patterns were identified: exophytic (6/21), intrinsic (2/21), and endo-exophytic (13/21). Eight patients (8/15, 53 %) harbored a BRAF V600E mutation. All recurrent tumors were endo-exophytic, and except the one without molecular information, were BRAF V600E mutants. A Cox hazard proportion ratio model was used to identify factors influencing EFS, including sex, age, location, growth patterns, extent of resection (EOR), and BRAF V600E mutation status. On univariate analysis, none of these factors reached statistical significance. Among them, EOR and growth patterns were strongly associated with each other (Fisher’s exact test, P  
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-016-2131-z