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Intraventricular choroid plexus tumors: clinical characteristics and impact of current management on survival

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Abstract

Introduction

Choroid plexus tumors (CPTs) represent one of the most common intraventricular tumors. Although most are benign, they often reach considerable sizes before clinical manifestation, challenging their surgical management. We aim to describe the clinical characteristics and the impact of current management on the survival of patients harboring intraventricular CPT.

Methods

The National Cancer Database (NCDB) was queried to identify biopsy-proven intraventricular CPT patients (2004–2015). Demographic and patterns of care were described, the log-rank method was used to independently analyze survival according to age, WHO grade and extent of resection (EOR). Multivariate analysis was performed to investigate the impact of prognostic factors on overall survival (OS).

Results

A total of 439 CPT patients with known WHO grade were included. WHO grade I tumors were more frequent in adults, while WHO grade III tumors were more common in pediatric population. Most CPTs were benign, with a median tumor size of 3–4 cm. Mean tumor size in pediatric population was greater than in adult population (4.39 cm vs. 2.7 cm; p < 0.01). Frequency was similar between males and females (51.7% vs. 48.3%; p > 0.0.5). Five- and ten-year OS among all patients was 87% and 84%, respectively. EOR was not associated with survival for any WHO grade. On multivariable analysis, only patient age (p = 0.022), WHO grade (p = 0.003) and medical comorbidity scores (p = 0.002) were independently associated with OS after diagnosis.

Conclusion

Patients with CPTs present at different stages of life, with sizable tumor burden and distinct WHO grade prevalence. Considering their favorable survival, efforts to improve tumor control should be meticulously weighed against the long-term risk associated with surgery, radiation, and chemotherapy.

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Data availability

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

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Funding

This publication was made possible through the support of the Eveleigh Family Career Development Award for Cancer Research at Mayo Clinic in Florida.

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Authors and Affiliations

  1. Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA

    Henry Ruiz-Garcia & Daniel M. Trifiletti

  2. Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA

    Henry Ruiz-Garcia, Diego Incontri, Juan J. Whaley, Lina Marenco-Hillembrand, James Ebot, Kaisorn L. Chaichana, Alfredo Quiñones-Hinojosa & Daniel M. Trifiletti

  3. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, USA

    Maria T. Huayllani

  4. Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA

    Jason Sheehan

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  1. Henry Ruiz-Garcia
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11060_2020_3603_MOESM1_ESM.pdf

Supplementary file1 (PDF 163 kb). Fig. 1a, b WHO grade distribution according to age (A) and sex (B).WHO: World Health Organization.

11060_2020_3603_MOESM2_ESM.pptx

Supplementary file2 (PPTX 1874 kb). Fig. 2 Kaplan-Meier curve of overall survival based on extent ofresection in WHO grade 2 (A) and WHO grade 3 (B) patients. WHO: World Health Organization.

11060_2020_3603_MOESM3_ESM.docx

Supplementary file3 (DOCX 31 kb). Tables 1, 2 Extend of resection according to age, WHO grade classification and tumor size; Use of radiation therapy or chemotherapy according to WHO grade classification.

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Ruiz-Garcia, H., Huayllani, M.T., Incontri, D. et al. Intraventricular choroid plexus tumors: clinical characteristics and impact of current management on survival. J Neurooncol 149, 283–292 (2020). https://doi.org/10.1007/s11060-020-03603-8

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