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Management and treatment of brain tumors during pregnancy: an Italian survey

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Abstract

Purpose

The management of brain tumors during pregnancy is challenging. The clinical rarity and prognostic heterogeneity of such condition makes it difficult to develop standardized guidelines of treatment. The aim of this study was to assess the treatment options used in pregnant women with brain tumors that are currently used in Italy, considering the management of these patients reported in current literature in this field.

Methods

A survey addressing the treatments options and management of brain tumors during pregnancy was designed on behalf of an ad-hoc task-force Neuro-Oncology committee of the Società Italiana di Neurochirurgia (SINch) to analyze the management of pregnant patients with brain tumors. We conducted a search of the literature published between January 2011 and September 2021, using MEDLINE (PubMed) in accordance to PRISMA guidelines. Data were discussed to obtain recommendations after evaluation of the selected articles and discussion among the experts.

Results

A total of 18 Neurosurgical centers participated in the survey. A total of 31 pregnant women were included in this retrospective study. Meningiomas and gliomas were the two most common types of brain tumors diagnosed during pregnancy. An emergency surgical procedure was required in 12.9% of cases.

Conclusion

A multidisciplinary and tailored approach is fundamental. In women showing clinical stability, neurosurgical options should preferably be delayed if possible, and considered during the second trimester or after delivery. In patients with acute neurological symptoms or tumor progression, medical abortion in the first trimester or a C-section in the second and third trimester need to be considered.

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Acknowledgements

N/A. Neuro-Oncology committee of the SINch (Società Italiana di Neurochirurgia) Collaborators Rosina Amoroso, Riccardo Boccaletti, Mariella Caffo, Franco Chioffi, Fabio Cofano, Pasquale de Bonis, Felice Esposito, Alberto Feletti, Diego Garbossa, Diego Mazzatenta, Domenico Policicchio, Giovanni Raffa, Francesco Sala, Alba Scerrati, Andrea Schwarz, Francesco Signorelli, Miran Skrap, Maria Tropeano, Francesco Volpin, Lorenzo Volpin, Gianpaolo Zabon, Matteo Zoli.

Funding

The authors declare that no financial support was received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Division of Neurosurgery, Department of Neurological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy

    Teresa Somma, Ilaria Bove, Francesca Vitulli & Paolo Cappabianca

  2. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

    Federico Pessina

  3. Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131, Naples, Italy

    Carlo Alviggi

  4. Neurosurgical Unit of Sondrio ASST - Valtellina e alto Lario, Sondrio, Italy

    Laura Santi

  5. Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00100, Rome, Italy

    Giuseppe Maria Della Pepa

  6. Department of Neurosurgery, Mater Olbia Hospital, Olbia, Italy

    Giovanni Sabatino

  7. Institute of Neurosurgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Catholic University, Rome, Italy

    Alessandro Olivi

  8. Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, Udine, Italy

    Tamara Ius

Authors
  1. Teresa Somma
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  2. Ilaria Bove
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  5. Federico Pessina
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  6. Carlo Alviggi
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  7. Laura Santi
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  8. Giuseppe Maria Della Pepa
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Consortia

Neuro-Oncology committee of the SINch (Società Italiana di Neurochirurgia)

  • Rosina Amoroso
  • , Riccardo Boccaletti
  • , Mariella Caffo
  • , Franco Chioffi
  • , Fabio Cofano
  • , Pasquale de Bonis
  • , Felice Esposito
  • , Alberto Feletti
  • , Diego Garbossa
  • , Diego Mazzatenta
  • , Domenico Policicchio
  • , Giovanni Raffa
  • , Francesco Sala
  • , Alba Scerrati
  • , Andrea Schwarz
  • , Francesco Signorelli
  • , Miran Skrap
  • , Maria Tropeano
  • , Francesco Volpin
  • , Lorenzo Volpin
  • , Gianpaolo Zabon
  • , Matteo Zoli
  • , Cesare Zoia
  •  & Daniele Bongetta

Contributions

All authors contributed to the study conception and design. Data collection, analysis, and the first draft were prepared by TS, and IB. All authors commented on previous versions of the draft. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ilaria Bove.

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Somma, T., Bove, I., Vitulli, F. et al. Management and treatment of brain tumors during pregnancy: an Italian survey. J Neurooncol 161, 13–22 (2023). https://doi.org/10.1007/s11060-022-04215-0

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