Neurosurgical Management of Brainstem Hemangioblastomas: A Single-Institution Experience with 116 Patients

Ma, Dongjie; Wang, Ying; Du, Guizhi; Zhou, Lei

doi:10.1016/j.wneu.2015.05.030

Cited by 19 publications

(15 citation statements)

References 39 publications

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“…Notably, due to small cohort sizes, there is very little data in the current literature assessing survival outcomes based on extent of resection. However, several studies have reported increased rate of intra-operative and post-operative hemorrhage in patients who underwent a partial resection, likely secondary to the highly vascular nature of the tumor 4 , 7 , 17 , 27 – 29 . This suggests that STR may carry a greater risk of morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…This may be particularly relevant for hemangioblastomas originating from the brainstem as these tumors were found to have worse OS when compared to cerebellar tumors in our cohort and are oftentimes proximal to critical structures. A number of studies have emphasized the need for meticulous resection of brainstem lesions for this reason 8 , 23 , 29 , 30 .…”

Section: Discussionmentioning

confidence: 99%

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Assessment of care pattern and outcome in hemangioblastoma

Huang

Chan²,

Bai

et al. 2018

Sci Rep

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Due to its rarity, current literature assessing prognostic factors and survival outcomes of hemangioblastoma is limited. Patients with histologically confirmed hemangioblastoma were identified from the US National Cancer Data Base. 1488 patients met inclusion criteria. 644 patients underwent gross total resection (GTR), 220 subtotal resection (STR)/biopsy, 60 stereotactic radiosurgery (SRS), 15 external beam radiotherapy (EBRT), 51 surgery followed by radiotherapy (SR + RT) and 498 no treatment. Independent predictors of shorter OS included age ≥ 40 (HR, 3.897; 95% CI, 2.341–6.487; p < 0.001), Charlson-Deyo score ≥ 1(HR, 1.756; 95% CI, 1.213–2.544; p = 0.003), tumor location in the brainstem (HR, 1.955; 95% CI, 1.129–3. 384; p = 0.017) compared to cerebellum, no treatment (HR, 2530; 95% CI, 1.533–4.177; p < 0.001) and receipt of EBRT (HR, 2.860; 95% CI, 1.073–7.618; p = 0.036) compared to STR/biopsy. GTR was associated with longer OS (HR 0.617; 95% CI, 0.391–0.974; p = 0.038), while SRS had comparable OS to STR/biopsy. The overall trend of OS by treatment modality was consistent after matching to age- and sex-matched US population data. In patients younger than 40 years, treatment was not a significant predictor of OS. In conclusion, GTR remained the optimal treatment for hemangioblastoma. SRS may perform similarly to surgery alone. Treatment was not a significant predictor of survival in younger patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessment of care pattern and outcome in hemangioblastoma

Huang

Chan²,

Bai

et al. 2018

Sci Rep

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“…Forty-one percent of the hemangioblastomas were associated with cyst formation. The size of the tumors or cysts was reported in 7 studies [4,10,13,15,17,36,37], and the mean diameter was 21.3 mm (range 2-56 mm). In total, 39.6% of the tumors were related to VHL disease [10, 13, 15, 17, 22, 33-35, 37, 40].…”

Section: Baseline Characteristicsmentioning

confidence: 99%

“…The most common region involved was the medulla oblongata (55.0%). According to the relationship between the tumor and surrounding parenchyma, 15.1% of brainstem hemangioblastomas were entirely intrabrainstem or intramedullary [4,10,13,15,17,34]. Details of the study characteristics are shown in Table 2.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

“…Consequently, surgical treatment for brainstem hemangioblastoma poses a significant challenge for neurosurgeons. To date, there have been many studies on the surgical outcomes of microsurgical resection of brainstem hemangioblastomas [4,10,13,15,17,22,[33][34][35][36][37][38]40]. We conducted a meta-analysis of surgical outcomes from the published literature to evaluate the safety and efficacy of surgical treatment for brainstem hemangioblastoma in this study.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of surgical treatment for brainstem hemangioblastoma: a meta-analysis

Yin

et al. 2020

Neurosurg Rev

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Brainstem hemangioblastomas are benign, highly vascular tumors located in the mesencephalon, pons, and medulla oblongata. Although surgical resection is currently considered the main therapeutic option for symptomatic lesions, evidence supporting the application of microsurgery has not been systematically assessed. This meta-analysis aims to evaluate the safety and efficacy of surgical treatment for brainstem hemangioblastomas. A comprehensive search of the PubMed, Embase, and Web of Science databases was performed to identify all English language publications reporting the outcomes of surgical treatment for brainstem hemangioblastomas. Studies from January 1990 to July 2019 with ≥ 10 cases were included. We analyzed the surgical outcomes, including gross total resection, mortality, neurological morbidity, and functional outcome according to the McCormick Scale or Karnofsky Performance Scale. Thirteen studies with 473 cases were included. The pooled proportion of gross total resection was 98% (95% confidence interval (CI), 94–100%). Overall mortality and neurological morbidity were 4 (95% CI, 2–6%) and 13% (95% CI, 7–20%), respectively. Favorable functional outcomes at the last follow-up were achieved in 85% (95% CI, 78–92%) of all patients. Improved or stable functional outcomes at long-term follow-up were achieved in 94% (95% CI, 89–97%) of patients. This meta-analysis revealed that surgical treatment for brainstem hemangioblastomas is technically feasible and effective with lasting patient benefits and cure.

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Brain Tumors

Wang

Zhou

et al. 2022

Pediatric Neuroimaging

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Neurosurgical Management of Brainstem Hemangioblastomas: A Single-Institution Experience with 116 Patients

Cited by 19 publications

References 39 publications

Assessment of care pattern and outcome in hemangioblastoma

Assessment of care pattern and outcome in hemangioblastoma

Safety and efficacy of surgical treatment for brainstem hemangioblastoma: a meta-analysis

Brain Tumors

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