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02.05.2023 | Research

Treatment of hydrocephalus following posterior fossa tumor resection: a multicenter collaboration from the Hydrocephalus Clinical Research Network

verfasst von: Michael C. Dewan, Albert M. Isaacs, Michael J Cools, Aaron Yengo-Kahn, Robert P. Naftel, Hailey Jensen, Ron W Reeder, Richard Holubkov, Joseline Haizel-Cobbina, Jay Riva-Cambrin, Ryan J Jafrani, Jonathan A Pindrik, Eric M. Jackson, Brendan F Judy, Elena Kurudza, Ian F. Pollack, Michael M. Mcdowell, Todd C. Hankinson, Susan Staulcup, Jason Hauptman, Koko Hall, Mandeep S Tamber, Alex Cheong, Nebras M. Warsi, Brandon G. Rocque, Benjamin W Saccomano, Rita I Snyder, Abhaya V. Kulkarni, John R. W. Kestle, John C. Wellons III, for the Hydrocephalus Clinical Research Network

Erschienen in: Journal of Neuro-Oncology | Ausgabe 1/2023

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Abstract

Objective

Persistent hydrocephalus following posterior fossa brain tumor (PFBT) resection is a common cause of morbidity in pediatric brain tumor patients, for which the optimal treatment is debated. The purpose of this study was to compare treatment outcomes between VPS and ETV in patients with persistent hydrocephalus following surgical resection of a PFBT.

Methods

A post-hoc analysis was performed of the Hydrocephalus Clinical Research Network (HCRN) prospective observational study evaluating VPS and ETV for pediatric patients. Children who experienced hydrocephalus secondary to PFBT from 2008 to 2021 were included. Primary outcomes were VPS/ETV treatment failure and time-to-failure (TTF).

Results

Among 241 patients, the VPS (183) and ETV (58) groups were similar in age, extent of tumor resection, and preoperative ETV Success Score. There was no difference in overall treatment failure between VPS and ETV (33.9% vs 31.0%, p = 0.751). However, mean TTF was shorter for ETV than VPS (0.45 years vs 1.30 years, p = 0.001). While major complication profiles were similar, compared to VPS, ETV patients had relatively higher incidence of minor CSF leak (10.3% vs. 1.1%, p = 0.003) and pseudomeningocele (12.1% vs 3.3%, p = 0.02). No ETV failures were identified beyond 3 years, while shunt failures occurred beyond 5 years. Shunt infections occurred in 5.5% of the VPS cohort.

Conclusions

ETV and VPS offer similar overall success rates for PFBT-related postoperative hydrocephalus. ETV failure occurs earlier, while susceptibility to VPS failure persists beyond 5 years. Tumor histology and grade may be considered when selecting the optimal means of CSF diversion.

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Titel: Treatment of hydrocephalus following posterior fossa tumor resection: a multicenter collaboration from the Hydrocephalus Clinical Research Network
verfasst von: Michael C. Dewan
Albert M. Isaacs
Michael J Cools
Aaron Yengo-Kahn
Robert P. Naftel
Hailey Jensen
Ron W Reeder
Richard Holubkov
Joseline Haizel-Cobbina
Jay Riva-Cambrin
Ryan J Jafrani
Jonathan A Pindrik
Eric M. Jackson
Brendan F Judy
Elena Kurudza
Ian F. Pollack
Michael M. Mcdowell
Todd C. Hankinson
Susan Staulcup
Jason Hauptman
Koko Hall
Mandeep S Tamber
Alex Cheong
Nebras M. Warsi
Brandon G. Rocque
Benjamin W Saccomano
Rita I Snyder
Abhaya V. Kulkarni
John R. W. Kestle
John C. Wellons III
for the Hydrocephalus Clinical Research Network
Publikationsdatum: 02.05.2023
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 1/2023
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-023-04316-4

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Treatment of hydrocephalus following posterior fossa tumor resection: a multicenter collaboration from the Hydrocephalus Clinical Research Network