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Neuroendoscopic biopsy and the treatment of tumor-associated hydrocephalus of the ventricular and paraventricular region in pediatric patients: a nationwide study in Japan

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Abstract

A neuroendoscopic biopsy is a minimally invasive and useful procedure for the diagnosis and initial management of tumor-associated hydrocephalus. We describe the nationwide investigation of the current status of neuroendoscopic biopsy for intra- and paraventricular tumors in children, as well as the treatment of tumor-associated hydrocephalus in pediatric patients. The main items examined included the patient’s age and sex, location of the tumor, pathological diagnosis, complications, treatment and efficacy of treatment of the tumor-associated hydrocephalus, and the dissemination during the postoperative course. Two hundred twenty-one pediatric patients (mean 8.6 years) from 67 institutions were registered. Endoscopic tumor biopsies were performed in 206 patients (93.2 %), and a histopathological diagnosis could be performed in 195 of these 206 patients (94.7 %). The most frequently histopathologically diagnosed tumor was a germ cell tumor (41.5 %), followed by astrocytic tumors (24.1 %) and cystic lesions (15.9 %). Associated hydrocephalus was observed in 177 patients (80.1 %), 101 of whom underwent endoscopic third ventriculostomy (ETV). The efficacy rate of the ETV in the perioperative period was 99.0 %, and the long-term response rate was 90.1 %. Perioperative complications other than fever were found in 24 patients (10.9 %). In the statistical analysis, pediatric long-term response rate to ETV (p = 0.025) showed significantly more favorable results for pediatric than adult patients (p < 0.05). Neuroendoscopic procedures involving pediatric intra- and paraventricular tumors were considered to be very useful, with a low incidence of complication, and were associated with higher safety.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo, 160-8582, Japan

    Tomoru Miwa & Takayuki Ohira

  2. Division of Neurosurgery, Shizuoka Cancer Center, Shizuoka, Japan

    Nakamasa Hayashi

  3. Department of Neurosurgery, University of Toyama, Toyama, Japan

    Shunro Endo

Authors
  1. Tomoru Miwa
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  2. Nakamasa Hayashi
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  3. Shunro Endo
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  4. Takayuki Ohira
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Corresponding author

Correspondence to Tomoru Miwa.

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Comments

Yavor Enchev, Varna, Bulgaria

Neuroendoscopy represents a valuable and reliable option for yielding a biopsy of intraventricular or paraventricular tumors. Its main advantages include minimal invasiveness, visual control of the procedure, and possibility for simultaneous treatment of the tumor-associated hydrocephalus.

The authors reported a nationwide study of the application of neuroendoscopy for biopsy of intra- and paraventricular tumors in a pediatric population, as well as for the treatment of tumor-associated hydrocephalus. The parameters like patient’s age, sex distribution, tumor localization, histological findings, procedure-related complications, simultaneous treatment of tumor-associated hydrocephalus and its efficacy, as well as tumor dissemination during the postoperative course were analyzed in detail retrospectively. The series included 221 patients treated neuroendoscopically during a period of 5 years (2005–2009) within 67 neurosurgical institutions.

The results evidently demonstrate that neuroendoscopic procedures for biopsy and treatment of the tumor-associated hydrocephalus in pediatric intra- and paraventricular tumors represent a reasonable option with high usefulness and insignificant complication rate.

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Miwa, T., Hayashi, N., Endo, S. et al. Neuroendoscopic biopsy and the treatment of tumor-associated hydrocephalus of the ventricular and paraventricular region in pediatric patients: a nationwide study in Japan. Neurosurg Rev 38, 693–704 (2015). https://doi.org/10.1007/s10143-015-0629-z

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  • DOI: https://doi.org/10.1007/s10143-015-0629-z

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