Incidence and risk factors for necessitating shunting following medulloblastoma surgery in Children: a monocenter, retrospective, observational cohort study

Abstract

Purpose: There have been insufficient data for pediatric patients with medulloblastoma who necessitate shunting following resection. This study aims to determine which characters are associated with the incidence in this patient subset. Methods: We surveyed this monocenter, retrospective, observational cohort of patients (aged 18 years or younger) who underwent medulloblastoma resection at our department between July 1, 2010, to August 1, 2021. The primary outcome was the incidence of necessitating permanent shunt censored after medulloblastoma surgery. Subject demographic, tumor biology, and interventions were analyzed using univariate and multivariable adjusted models. Results: 183 patients were admitted to our department. Of these, 131 (71·6%) patients participated. The incidence of necessitating permanent shunt was 25.6% (95% CI: 18.7-34.3). Factors that were independently associated with the incidence were medulloblastoma volume > 46381.5mm3 (OR: 2.919, 95% CI: 1.191-7.156) and ventricular infiltration (OR: 2.849, 95% CI: 1.142-7.102). Manifestations duration could be a covariate of tumor volume and increased risk of shunt need (OR: 1.006, 95% CI: 1.000-1.013). Besides, tumor volume was a probable predictor in patients with subtotal resection (OR: 4.900, 95% CI: 0.992-24.208, P=0.051). Lastly, there was no significant difference between the distribution of molecular subgroups for necessitating permanent shunt patients. Conclusion: Increased incidence was associated with medulloblastoma invasion. Our study implies that the presence of postresection hydrocephalus in patients with medulloblastoma was not high enough to entail a prophylactic permanent shunt in all patients.