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Characteristics and management of hydrocephalus in adult patients with cerebellar glioblastoma: lessons from a French nationwide series of 118 cases

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Abstract

The characteristics of hydrocephalus associated with cerebellar glioblastoma (cGB) remain poorly known. The objectives were to describe the occurence of hydrocephalus in a French nationwide series of adult patients with cGB, to identify the characteristics associated with hydrocephalus and to analyze the outcomes associated with the different surgical strategies, in order to propose practical guidelines. Consecutive cases of adult cGB patients prospectively recorded into the French Brain Tumor Database between 2003 and 2017 were screened. Diagnosis was confirmed by a centralized neuropathological review. Among 118 patients with cGB (mean age 55.9 years), 49 patients (41.5%) presented with pre-operative hydrocephalus. Thirteen patients (11.0%) developed acute (n=7) or delayed (n=6) hydrocephalus postoperatively. Compared to patients without hydrocephalus at admission, patients with hydrocephalus were younger (52.0 years vs 58.6 years, p=0.03) and underwent more frequently tumor resection (93.9% vs 73.9%, p=0.006). A total of 40 cerebrospinal-fluid diversion procedures were performed, including 18 endoscopic third ventriculostomies, 12 ventriculoperitoneal shunts and 10 external ventricular drains. The different cerebrospinal-fluid diversion options had comparable functional results and complication rates. Among the 89 patients surgically managed for cGB without prior cerebrospinal-fluid diversion, 7 (7.9%) were long-term shunt-dependant. Hydrocephalus is frequent in patients with cGB and has to be carefully managed in order not to interfere with adjuvant oncological treatments. In case of symptomatic hydrocephalus, a cerebrospinal-fluid diversion is mandatory, especially if surgical resection is not feasible. In case of asymptomatic hydrocephalus, a cerebrospinal-fluid diversion has to be discussed only if surgical resection is not feasible.

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Acknowledgements

We thank all contributors from the French Brain Tumor Database and from the Club de Neuro-Oncologie of the Société Française de Neurochirurgie and Mr Julien Berthiller, biostatistician. Moreover, we thank the non-profit organizations that support the FBTDB: Ligue Nationale Contre le Cancer and comité 34, Associations pour la Recherche sur les Tumeurs Cérébrales (ARTC) Nord et Sud, Des étoiles dans la Mer ; as well as the French Glioblastoma biobank (FGB) and the French Institut National du Cancer-INCa.

Data Availability (data transparency)

Anonymized data will be shared by request from any qualified investigator.

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Funding

No funding was received for conducting this study.

Author information

Author notes

  1. Luc Bauchet and Jacques Guyotat contributed equally to this work.

Authors and Affiliations

  1. Hospices Civils de Lyon, Hopital Neurologique Pierre Wertheimer, Department of Neurosurgery, 59 Boulevard Pinel, 69667, Bron, France

    Thiébaud Picart, Chloé Dumot, Isabelle Pelissou-Guyotat, Moncef Berhouma & Jacques Guyotat

  2. Claude Bernard University, Lyon, France

    Thiébaud Picart, Chloé Dumot, David Meyronet, François Ducray & Moncef Berhouma

  3. Department of Cancer Cell Plasticity–INSERM U1052, Cancer Research Center of Lyon, Lyon, France

    Thiébaud Picart, David Meyronet & François Ducray

  4. CarMeN laboratory, Inserm U1060, INRA U1397 INSA Lyon, Université Claude Bernard Lyon 1, Lyon, France

    Chloé Dumot

  5. Hospices Civils de Lyon, Groupe Hospitalier Est, Department of Neuropathology, Bron, France

    David Meyronet

  6. GHU Paris, Site Sainte-Anne, Department of Neurosurgery, Paris, France

    Johan Pallud

  7. Universités de Paris, Paris, France

    Johan Pallud

  8. IMA-Brain, INSERM U894, Institut de Psychiatrie et Neurosciences de Paris, Paris, France

    Johan Pallud

  9. Privé Clairval, Ramsay Général de Santé, Marseille, France

    Philippe Metellus

  10. Institut de Neurophysiopathologie-UMR 7051, Université d’Aix-Marseille, Marseille, France

    Philippe Metellus

  11. Department of Neurosurgery CHU, Montpellier University Hospital, Montpellier, France

    Sonia Zouaoui & Luc Bauchet

  12. FBTDB (French Brain Tumor DataBase), ICM, Montpellier, France

    Sonia Zouaoui & Luc Bauchet

  13. Hospices Civils de Lyon, Hopital Neurologique Pierre Wertheimer, Department of Neurooncology, Bron, France

    François Ducray

  14. CREATIS Laboratory, Inserm U1206, UMR 5220, Université de Lyon, Villeurbanne, France

    Moncef Berhouma

  15. Institut des Neurosciences de Montpellier - INSERM U1051, Hôpital Saint Eloi, Montpellier, France

    Luc Bauchet

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Consortia

French Brain Tumor DataBase

Club de Neuro-Oncologie of the Société Française de Neurochirurgie

Contributions

Thiébaud Picart, Luc Bauchet and Jacques Guyotat designed and conceptualized the study.

Thiébaud Picart, Chloé Dumot, David Meyronet, Johan Pallud, Philippe Metellus, Sonia Zouaoui, François Ducray, Isabelle Pelissou-Guyotat, Moncef Berhouma and all members from the French Brain Tumor DataBase and the Club de Neuro-Oncologie of the Société Française de Neurochirurgie had a major role in the acquisition of data.

Thiébaud Picart and David Meyronet analyzed and interpreted the data.

Thiébaud Picart, Luc Bauchet and Jacques Guyotat drafted the manuscript.

All authors critically revised the manuscript for intellectual content and approved the final version.

Corresponding author

Correspondence to Thiébaud Picart.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the French legislation (CCTIRS n°10.548; CNIL n°911013).

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All patients provided written informed consent for study inclusion.

Consent for publication (include appropriate statements)

All living patients provided written informed consent for data publication.

Conflicts of interest

Drs. Thiébaud Picart, Chloé Dumot, David Meyronet, Johan Pallud, Philippe Metellus, Sonia Zouaoui, François Ducray, Isabelle Pelissou-Guyotat, Moncef Berhouma, Luc Bauchet, Jacques Guyotat, all members of the French Brain Tumor DataBase and Club de Neuro-Oncologie of the Société Française de Neurochirurgie declare that they have no conflict of interest.

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Picart, T., Dumot, C., Meyronet, D. et al. Characteristics and management of hydrocephalus in adult patients with cerebellar glioblastoma: lessons from a French nationwide series of 118 cases. Neurosurg Rev 45, 683–699 (2022). https://doi.org/10.1007/s10143-021-01578-2

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