Journal Article

Clinical Features and Prognostic Risk Factors of Choroid Plexus Tumors in Children

Zhou, Wen-Jian-Long, Zhang, Dai-Nan, Guan, Xiu-Dong, Li, Chun-De, Peng, Jia-Yi, Ma, Shun-Chang, Jia, Wang, Niu, Jian-Xing, Diao, Jin-Fu, Wang, Xi

2018

Overview

Background: Decision-making concerning the treatment of choroid plexus tumor (CPT) in pediatric patients remains a topic of considerable debate. The aim of this work was to describe clinical features and prognostic risk factors of CPT in the pediatric population and to provide theoretical opinions regarding clinical decisions for CPT. Methods: The data of 96 patients with CPT and younger than 14 years were retrospectively analyzed. Clinical characteristics such as pathological type of CPTs, rate and severity of hydrocephalus, treatment and outcome, and recurrence were investigated. For categorical variables, the Pearson's Chi-square test was performed. The Mann-Whitney U-test was used for comparisons between nonnormally distributed parameters. Log-rank test was used for progression-free survival (PFS). Results: The study included 70 choroid plexus papilloma (CPP) cases, 17 atypical choroid plexus papilloma (aCPP) cases, and 9 choroid plexus carcinoma (CPC) cases. Compared with patients with CPP or aCPP, patients with CPC had a shorter disease course (median: CPP, 4 months; aCPP, 2 months; CPC, 1 month; H: 23.5, P < 0.001), higher rate of acute hydrocephalus (CPP, 27.1%; aCPP, 52.9%; CPC, 77.8%; χ2 = 10.9, P < 0.05), and lower incidence of cure rate (CPP, 85.7%; aCPP, 70.5%; CPC, 33.3%; χ2 = 13.5, P < 0.05). The severity of hydrocephalus with tumor in the lateral or third ventricle was significantly higher than that with tumors in the fourth ventricle (severe hydrocephalus: lateral ventricle, 51.7%; third ventricle, 47.0%; fourth ventricle, 11.1%; χ2 = 26.0, P < 0.001). Patients with gross total surgical resection had no better PFS than those with partial resection because of the use of adjuvant therapy in the latter (χ2 = 4.0, P > 0.05). Patients with CPC experienced shorter time for recurrence than those with CPP or aCPP (χ2 = 40.1, P < 0.0001). Conclusions: Our results indicated that CPP in the fourth ventricle could trigger serious clinical symptoms at an early stage, requiring early intervention. Adjuvant treatment might be necessary for patients with partially resected CPP, aCPP, and CPC to achieve a favorable outcome.

• Publisher: Wolters Kluwer India Pvt. Ltd,Medknow Publications and Media Pvt. Ltd,Lippincott Williams & Wilkins Ovid Technologies,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China%Department of Neurosurgery, Beijing Fuxing Hospital, Capital Medical University, Beijing 100050, China%Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China,Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China%Department of Neurosurgery, Beijing Armed Police General Hospital, Beijing 100000, China,Medknow Publications & Media Pvt Ltd,Wolters Kluwer
• Subject: Age / Analysis / Ataxia / Atypical Choroid Plexus Papilloma; Choroid Plexus Carcinoma; Choroid Plexus Papilloma; Pediatric Patients / Brain cancer / Brain tumors / Care and treatment / Chemotherapy / Child / Child, Preschool / Children / Choroid Plexus Neoplasms - mortality / Choroid Plexus Neoplasms - pathology / Choroid Plexus Neoplasms - surgery / Family medical history / Female / Health aspects / Hospitals / Humans / Hydrocephalus - etiology / Infant / Male / Medical prognosis / Medical records / Neoplasm Metastasis / Neoplasm Recurrence, Local / NMR / Nuclear magnetic resonance / Original / Pediatrics / Prognosis / Radiation therapy / Risk assessment / Risk Factors / Surgery / Tumors