Prognostic factors for recurrence and complications in the surgical management of primary chordoid gliomas: A systematic review of literature

Leonel Ampie, Winward Choy, Jonathan B. Lamano, Kartik Kesavabhotla, Qinwen Mao, Andrew T. Parsa, Orin Bloch

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective Chordoid gliomas (CG) are rare neoplasms which frequently arise within the third ventricle. Surgery remains the mainstay treatment for CG. The present study comprehensively reviews all reported cases of CG within the literature in order to identify risk factors for surgical complications and tumor recurrence. Methods A comprehensive search on MEDLINE (OVID and PubMed), Scopus, Embase, and Web of Science was conducted following PRISMA guidelines to identify all reported cases of CG. Results A total of 81 patients met the study criteria which comprised of 33 males and 48 females. Median age at diagnosis was 48 years with a range from 5 to 72 years, and mean tumor size was 3.1 cm. Biopsy, subtotal resection (STR), and gross total resection (GTR) were achieved in 8, 34, and 33 patients, respectively, with six cases not reporting extent of resection (EOR). Thirteen patients underwent adjuvant radiotherapy. Postoperative complications were noted in 30 cases (37%), with new onset diabetes insipidus being the most common. Postoperative morbidity was not associated with age, tumor size, or extent of resection. A trans-lamina terminalis approach demonstrated a strong trend towards decreased overall rates of postoperative morbidity compared to other approaches (p = 0.051). GTR was associated with improved progression-free survival (PFS; p = 0.028), while adjuvant radiotherapy, age, tumor size and proliferative index were not predictive of patient outcomes. Conclusion GTR should be the primary goal for the management of CG, as it is associated with improved rates of tumor control without an increased rate of postoperative complications. Surgical approach was a stronger predictor of complication rates than extent of resection. Morbidity remains high, and future studies to further elaborate on factors predictive of postoperative complications are critical.

Original languageEnglish (US)
Article number4153
Pages (from-to)129-136
Number of pages8
JournalClinical Neurology and Neurosurgery
Volume138
DOIs
StatePublished - Nov 1 2015
Externally publishedYes

Fingerprint

Notochord
Glioma
Recurrence
Neoplasms
Adjuvant Radiotherapy
Morbidity
Diabetes Insipidus
Third Ventricle
PubMed
MEDLINE
Hypothalamus
Disease-Free Survival
Guidelines
Biopsy

Keywords

  • Chordoid
  • Diabetes insipidus
  • Glioma
  • Hypothalamic dysfunction
  • Radiosurgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Prognostic factors for recurrence and complications in the surgical management of primary chordoid gliomas : A systematic review of literature. / Ampie, Leonel; Choy, Winward; Lamano, Jonathan B.; Kesavabhotla, Kartik; Mao, Qinwen; Parsa, Andrew T.; Bloch, Orin.

In: Clinical Neurology and Neurosurgery, Vol. 138, 4153, 01.11.2015, p. 129-136.

Research output: Contribution to journalArticle

Ampie, Leonel ; Choy, Winward ; Lamano, Jonathan B. ; Kesavabhotla, Kartik ; Mao, Qinwen ; Parsa, Andrew T. ; Bloch, Orin. / Prognostic factors for recurrence and complications in the surgical management of primary chordoid gliomas : A systematic review of literature. In: Clinical Neurology and Neurosurgery. 2015 ; Vol. 138. pp. 129-136.
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abstract = "Objective Chordoid gliomas (CG) are rare neoplasms which frequently arise within the third ventricle. Surgery remains the mainstay treatment for CG. The present study comprehensively reviews all reported cases of CG within the literature in order to identify risk factors for surgical complications and tumor recurrence. Methods A comprehensive search on MEDLINE (OVID and PubMed), Scopus, Embase, and Web of Science was conducted following PRISMA guidelines to identify all reported cases of CG. Results A total of 81 patients met the study criteria which comprised of 33 males and 48 females. Median age at diagnosis was 48 years with a range from 5 to 72 years, and mean tumor size was 3.1 cm. Biopsy, subtotal resection (STR), and gross total resection (GTR) were achieved in 8, 34, and 33 patients, respectively, with six cases not reporting extent of resection (EOR). Thirteen patients underwent adjuvant radiotherapy. Postoperative complications were noted in 30 cases (37{\%}), with new onset diabetes insipidus being the most common. Postoperative morbidity was not associated with age, tumor size, or extent of resection. A trans-lamina terminalis approach demonstrated a strong trend towards decreased overall rates of postoperative morbidity compared to other approaches (p = 0.051). GTR was associated with improved progression-free survival (PFS; p = 0.028), while adjuvant radiotherapy, age, tumor size and proliferative index were not predictive of patient outcomes. Conclusion GTR should be the primary goal for the management of CG, as it is associated with improved rates of tumor control without an increased rate of postoperative complications. Surgical approach was a stronger predictor of complication rates than extent of resection. Morbidity remains high, and future studies to further elaborate on factors predictive of postoperative complications are critical.",
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N2 - Objective Chordoid gliomas (CG) are rare neoplasms which frequently arise within the third ventricle. Surgery remains the mainstay treatment for CG. The present study comprehensively reviews all reported cases of CG within the literature in order to identify risk factors for surgical complications and tumor recurrence. Methods A comprehensive search on MEDLINE (OVID and PubMed), Scopus, Embase, and Web of Science was conducted following PRISMA guidelines to identify all reported cases of CG. Results A total of 81 patients met the study criteria which comprised of 33 males and 48 females. Median age at diagnosis was 48 years with a range from 5 to 72 years, and mean tumor size was 3.1 cm. Biopsy, subtotal resection (STR), and gross total resection (GTR) were achieved in 8, 34, and 33 patients, respectively, with six cases not reporting extent of resection (EOR). Thirteen patients underwent adjuvant radiotherapy. Postoperative complications were noted in 30 cases (37%), with new onset diabetes insipidus being the most common. Postoperative morbidity was not associated with age, tumor size, or extent of resection. A trans-lamina terminalis approach demonstrated a strong trend towards decreased overall rates of postoperative morbidity compared to other approaches (p = 0.051). GTR was associated with improved progression-free survival (PFS; p = 0.028), while adjuvant radiotherapy, age, tumor size and proliferative index were not predictive of patient outcomes. Conclusion GTR should be the primary goal for the management of CG, as it is associated with improved rates of tumor control without an increased rate of postoperative complications. Surgical approach was a stronger predictor of complication rates than extent of resection. Morbidity remains high, and future studies to further elaborate on factors predictive of postoperative complications are critical.

AB - Objective Chordoid gliomas (CG) are rare neoplasms which frequently arise within the third ventricle. Surgery remains the mainstay treatment for CG. The present study comprehensively reviews all reported cases of CG within the literature in order to identify risk factors for surgical complications and tumor recurrence. Methods A comprehensive search on MEDLINE (OVID and PubMed), Scopus, Embase, and Web of Science was conducted following PRISMA guidelines to identify all reported cases of CG. Results A total of 81 patients met the study criteria which comprised of 33 males and 48 females. Median age at diagnosis was 48 years with a range from 5 to 72 years, and mean tumor size was 3.1 cm. Biopsy, subtotal resection (STR), and gross total resection (GTR) were achieved in 8, 34, and 33 patients, respectively, with six cases not reporting extent of resection (EOR). Thirteen patients underwent adjuvant radiotherapy. Postoperative complications were noted in 30 cases (37%), with new onset diabetes insipidus being the most common. Postoperative morbidity was not associated with age, tumor size, or extent of resection. A trans-lamina terminalis approach demonstrated a strong trend towards decreased overall rates of postoperative morbidity compared to other approaches (p = 0.051). GTR was associated with improved progression-free survival (PFS; p = 0.028), while adjuvant radiotherapy, age, tumor size and proliferative index were not predictive of patient outcomes. Conclusion GTR should be the primary goal for the management of CG, as it is associated with improved rates of tumor control without an increased rate of postoperative complications. Surgical approach was a stronger predictor of complication rates than extent of resection. Morbidity remains high, and future studies to further elaborate on factors predictive of postoperative complications are critical.

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