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Increasing value of autopsies in patients with brain tumors in the molecular era

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Abstract

Background

Pediatric brain tumors are associated with high morbidity and mortality, in part due to insufficient understanding of tumor biology. With limited tissue allocation for research from surgical specimens, a key barrier to improving biological understanding, brain tumor autopsies have become an increasingly valuable resource. This study reviews the brain tumor autopsy practice at our institution and describes specific emerging research utilization patterns beyond the clinical autopsy report.

Methods

We performed a retrospective analysis of brain tumor autopsies at Boston Children’s Hospital (BCH) between 2007 and 2017 and reviewed their consents, neuropathology reports and final diagnoses. We reviewed the method of tissue triaging for research consented autopsies (bioregistry, frozen and fresh tissue) and documented their specific uses.

Results

Ninety-six deaths at BCH were due to brain tumors; 56 autopsies were performed (58.3%), of which 49 (87.5%) were consented for research. Tumor mapping was performed on all cases and tissue was allocated for DNA- and RNA-based sequencing studies (published and ongoing). Three tissue allocations with a postmortem interval of 8 h or less resulted in successful cell lines. Tissue from 14 autopsies was contributed to the National DIPG Registry.

Conclusion

Our institutional pediatric brain tumor autopsy clinical experience demonstrates the increased utility and wide utilization of autopsy-derived tissue for multiple types of research. These results support the increased efforts to obtain research consent for brain tumor autopsy and active collection of unfixed autopsy material in the molecular era.

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Acknowledgements

We are grateful for the support we receive from the pathology assistants and autopsy technicians, as well as for the support and collaboration of Boston Children’s Hospital Biorepository. Also, we acknowledge and thank the families that consented to autopsy research.

Funding

No funds were used for this particular manuscript and analysis.

Author information

Author notes

  1. Mark W. Kieran

    Present address: Brystol Meyers Squibb, New York, USA

Authors and Affiliations

  1. Department of Pathology, Beth Israel Deaconess Medical Center, Boston, USA

    Jared T. Ahrendsen

  2. Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, USA

    Mariella G. Filbin, Susan N. Chi, Peter E. Manley, Karen D. Wright, Pratiti Bandopadhayay, Jessica R. Clymer, Kee Kiat Yeo, Mark W. Kieran, Robert Jones & Sanda Alexandrescu

  3. Department of Pathology, Brigham and Women’s Hospital, Boston, USA

    Keith L. Ligon

  4. Department of Pathology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02215, USA

    Hart G. Lidov, Keith L. Ligon & Sanda Alexandrescu

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  1. Jared T. Ahrendsen
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Correspondence to Sanda Alexandrescu.

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Ahrendsen, J.T., Filbin, M.G., Chi, S.N. et al. Increasing value of autopsies in patients with brain tumors in the molecular era. J Neurooncol 145, 349–355 (2019). https://doi.org/10.1007/s11060-019-03302-z

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  • DOI: https://doi.org/10.1007/s11060-019-03302-z

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