Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma

OBJECTIVE Diffuse intrinsic pontine glioma (DIPG) is a highly aggressive and lethal brainstem tumor in children. In the 1980s, routine biopsy at presentation was abandoned since it was claimed "unnecessary" for diagnosis. In the last decade, however, several groups have reincorporated this...

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Autores: Lobon-Iglesias MJ, Santa-Maria Lopez V, Puerta Roldan P, Candela-Cantó S, Ramos-Albiac M, Gomez-Chiari M, Puget S, Bolle S, Goumnerova L, Kieran MW, Cruz O, Grill J, Morales La Madrid A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p14880
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=14880
Access Level:acceso abierto
Palabra clave:DIPG
dissemination
biopsy
oncology
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spelling Tumor dissemination through surgical tracts in diffuse intrinsic pontine gliomaLobon-Iglesias MJSanta-Maria Lopez VPuerta Roldan PCandela-Cantó SRamos-Albiac MGomez-Chiari MPuget SBolle SGoumnerova LKieran MWCruz OGrill JMorales La Madrid ADIPGdisseminationbiopsyoncologyOBJECTIVE Diffuse intrinsic pontine glioma (DIPG) is a highly aggressive and lethal brainstem tumor in children. In the 1980s, routine biopsy at presentation was abandoned since it was claimed "unnecessary" for diagnosis. In the last decade, however, several groups have reincorporated this procedure as standard of care or in the context of clinical trials. Expert neurosurgical teams report no mortality and acceptable morbidity, and no relevant complications have been previously described. The aim of this study was to review needle tract dissemination as a potential complication in DIPG. METHODS The authors retrospectively analyzed the incidence of dissemination through surgical tracts in DIPG patients who underwent biopsy procedures at diagnosis in 3 dedicated centers. Clinical records and images as well as radiation dosimetry from diagnosis to relapse were reviewed. RESULTS Four patients (2 boys and 2 girls, age range 6-12 years) had surgical tract dissemination: in 3 cases in the needle tract and in 1 case in the Ommaya catheter tract. The median time from biopsy to identification of dissemination was 5 months (range 4-6 months). The median overall survival was 11 months (range 7-12 months). Disseminated lesions were in the marginal radiotherapy field (n = 2), out of the field (n = 1), and in the radiotherapy field (n = 1). CONCLUSIONS Although surgical tract dissemination in DIPG is a rare complication (associated with 2.4% of procedures in this study), it should be mentioned to patients and family when procedures involving a surgical tract are proposed. The inclusion of the needle tract in the radiotherapy field may have only limited benefit. Future studies are warranted to explore the benefit of larger radiotherapy fields in patients with DIPG.AMER ASSOC NEUROLOGICAL SURGEONS2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=14880Journal of Neurosurgery-PediatricsISSN: 19330707ISSNe: 19330715reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p148802026-05-27T12:37:41Z
dc.title.none.fl_str_mv Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma
title Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma
spellingShingle Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma
Lobon-Iglesias MJ
DIPG
dissemination
biopsy
oncology
title_short Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma
title_full Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma
title_fullStr Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma
title_full_unstemmed Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma
title_sort Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma
dc.creator.none.fl_str_mv Lobon-Iglesias MJ
Santa-Maria Lopez V
Puerta Roldan P
Candela-Cantó S
Ramos-Albiac M
Gomez-Chiari M
Puget S
Bolle S
Goumnerova L
Kieran MW
Cruz O
Grill J
Morales La Madrid A
author Lobon-Iglesias MJ
author_facet Lobon-Iglesias MJ
Santa-Maria Lopez V
Puerta Roldan P
Candela-Cantó S
Ramos-Albiac M
Gomez-Chiari M
Puget S
Bolle S
Goumnerova L
Kieran MW
Cruz O
Grill J
Morales La Madrid A
author_role author
author2 Santa-Maria Lopez V
Puerta Roldan P
Candela-Cantó S
Ramos-Albiac M
Gomez-Chiari M
Puget S
Bolle S
Goumnerova L
Kieran MW
Cruz O
Grill J
Morales La Madrid A
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv DIPG
dissemination
biopsy
oncology
topic DIPG
dissemination
biopsy
oncology
description OBJECTIVE Diffuse intrinsic pontine glioma (DIPG) is a highly aggressive and lethal brainstem tumor in children. In the 1980s, routine biopsy at presentation was abandoned since it was claimed "unnecessary" for diagnosis. In the last decade, however, several groups have reincorporated this procedure as standard of care or in the context of clinical trials. Expert neurosurgical teams report no mortality and acceptable morbidity, and no relevant complications have been previously described. The aim of this study was to review needle tract dissemination as a potential complication in DIPG. METHODS The authors retrospectively analyzed the incidence of dissemination through surgical tracts in DIPG patients who underwent biopsy procedures at diagnosis in 3 dedicated centers. Clinical records and images as well as radiation dosimetry from diagnosis to relapse were reviewed. RESULTS Four patients (2 boys and 2 girls, age range 6-12 years) had surgical tract dissemination: in 3 cases in the needle tract and in 1 case in the Ommaya catheter tract. The median time from biopsy to identification of dissemination was 5 months (range 4-6 months). The median overall survival was 11 months (range 7-12 months). Disseminated lesions were in the marginal radiotherapy field (n = 2), out of the field (n = 1), and in the radiotherapy field (n = 1). CONCLUSIONS Although surgical tract dissemination in DIPG is a rare complication (associated with 2.4% of procedures in this study), it should be mentioned to patients and family when procedures involving a surgical tract are proposed. The inclusion of the needle tract in the radiotherapy field may have only limited benefit. Future studies are warranted to explore the benefit of larger radiotherapy fields in patients with DIPG.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=14880
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=14880
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv AMER ASSOC NEUROLOGICAL SURGEONS
publisher.none.fl_str_mv AMER ASSOC NEUROLOGICAL SURGEONS
dc.source.none.fl_str_mv Journal of Neurosurgery-Pediatrics
ISSN: 19330707
ISSNe: 19330715
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
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collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
repository.name.fl_str_mv
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