Journal of Neuro-Oncology

, Volume 116, Issue 1, pp 179–185

Gross total resection improves overall survival in children with choroid plexus carcinoma

  • Matthew Z. Sun
  • Michael E. Ivan
  • Aaron J. Clark
  • Michael C. Oh
  • Arthur R. Delance
  • Taemin Oh
  • Michael Safaee
  • Gurvinder Kaur
  • Orin Bloch
  • Annette Molinaro
  • Nalin Gupta
  • Andrew T. Parsa
Clinical Study

DOI: 10.1007/s11060-013-1281-5

Cite this article as:
Sun, M.Z., Ivan, M.E., Clark, A.J. et al. J Neurooncol (2014) 116: 179. doi:10.1007/s11060-013-1281-5

Abstract

Choroid plexus carcinoma (CPC) is a rare, malignant, primary brain tumor with a poor prognosis. While previous reports have shown benefits of aggressive surgery, very few large-scale studies have focused exclusively on the pediatric population, for whom the risks of aggressive surgery must be weighed carefully against the benefits. We performed a comprehensive systematic review of pediatric CPCs to test the effects of gross total resection (GTR) on overall survival (OS) and progression-free survival (PFS). A Pubmed search was performed to identify children with CPC who underwent surgical resection. Only disaggregated clinical cases in which extent of resection was confirmed by CT or MRI were included for analysis. Kaplan–Meier and multivariate Cox regression survival analyses were performed to determine the effects of extent of resection on OS and PFS. Disaggregated clinical data from a total of 102 pediatric CPC patients (age ≤18 years) with known extent of resection and overall survival were analyzed. GTR was significantly associated with better OS by Kaplan–Meier analysis (logrank p < 0.001). Multivariate Cox regression analysis adjusting for age, gender, tumor location (supratentorial vs. infratentorial), and type of adjuvant therapy (chemotherapy, radiation, and combined therapy), showed that GTR independently increased OS (p = 0.006). While GTR also improved PFS on Kaplan–Meier analysis (p = 0.027), the effect did not meet our criteria for significance in our multivariate Cox model (p = 0.120). GTR improved OS of pediatric CPC and is recommended if it can be safely performed.

Keywords

Choroid plexus carcinomaExtent of resectionGross total resectionOverall survivalProgression free survivalPediatric

Abbreviations

GTR

Gross total resection

STR

Subtotal resection

OS

Overall survival

PFS

Progression free survival

EOR

Extent of resection

CI

Confidence interval

Supplementary material

11060_2013_1281_MOESM1_ESM.docx (43 kb)
Supplementary material 1 (DOCX 43 kb)

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Matthew Z. Sun
    • 1
  • Michael E. Ivan
    • 1
  • Aaron J. Clark
    • 1
  • Michael C. Oh
    • 1
  • Arthur R. Delance
    • 1
  • Taemin Oh
    • 3
  • Michael Safaee
    • 1
  • Gurvinder Kaur
    • 3
  • Orin Bloch
    • 3
  • Annette Molinaro
    • 1
  • Nalin Gupta
    • 1
    • 2
  • Andrew T. Parsa
    • 3
  1. 1.Department of Neurological SurgeryUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Department of PediatricsUniversity of California San FranciscoSan FranciscoUSA
  3. 3.Department of Neurological Surgery, Feinberg School of MedicineNorthwestern UniversityChicagoUSA