The relative patient benefit of gross total resection in adult choroid plexus papillomas

Michael Safaee, Michael C. Oh, Michael E. Sughrue, Arthur R. Delance, Orin Bloch, Matthew Sun, Gurvinder Kaur, Annette M. Molinaro, Andrew T. Parsa

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Choroid plexus papillomas are rare neuroepithelial tumors found mainly in children. Although well studied in the pediatric population, there is a paucity of literature focusing specifically on adults. We sought to assess the relative advantage of gross total resection (GTR) and further characterize the natural history of this disease in adults. A comprehensive PubMed search was performed to identify adults who underwent surgical resection for choroid plexus papillomas with clearly reported age, tumor location, and extent of resection. Kaplan-Meier analysis was used to assess progression-free survival (PFS) and overall survival (OS). Multivariate analysis was performed using Cox proportional hazards models. A total of 193 patients were identified with a mean age of 39.9 ± 1.1 years. GTR was achieved in 72% of patients with subtotal resection (STR) in 28%. GTR was associated with a significant increase in both PFS (p = 0.015) and OS (p = 0.004) compared to STR. In a multivariate Cox proportional hazards model we found that only GTR was associated with recurrence (hazard ratio [HR] = 0.47, 95% confidence interval [CI] 0.25-0.90), while both age (HR= 1.03, 95% CI 1.00-1.05) and GTR(HR = 0.36, 95% CI 0.17-0.78) were associated with OS. Interestingly, our observed recurrence and death rates were higher than those in previously published studies. These findings demonstrate the benefit of GTR for the treatment of choroid plexus papillomas in adults. Our analysis suggests that these lesions are not as indolent as previously thought and while GTR is preferred, it is not always curative.

Original languageEnglish (US)
Pages (from-to)808-812
Number of pages5
JournalJournal of Clinical Neuroscience
Volume20
Issue number6
DOIs
StatePublished - Jun 2013
Externally publishedYes

Keywords

  • Adult
  • Choroid plexus papilloma
  • Extent of resection
  • Overall survival
  • Tumor recurrence

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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  • Cite this

    Safaee, M., Oh, M. C., Sughrue, M. E., Delance, A. R., Bloch, O., Sun, M., Kaur, G., Molinaro, A. M., & Parsa, A. T. (2013). The relative patient benefit of gross total resection in adult choroid plexus papillomas. Journal of Clinical Neuroscience, 20(6), 808-812. https://doi.org/10.1016/j.jocn.2012.08.003