Space-occupying Tumor Bed Cysts as a Complication of Modern Treatment for High Grade Glioma.

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Space-occupying Tumor Bed Cysts as a Complication of Modern Treatment for High Grade Glioma.

World Neurosurg. 2017 May 13;:

Authors: Beez T, Burgula S, Kamp M, Rapp M, Steiger HJ, Sabel M

Abstract
INTRODUCTION: Management of high grade glioma (HGG) was changed by recent landmark trials and is nowadays more proactive. However, aggressive treatment leads to hospitalization due to side effects. Space-occupying tumor bed cysts have been described, but not systematically assessed. We sought to analyze this complication in a contemporary HGG cohort.
METHODS: A retrospective review of HGG patients treated between 2007 and 2013 was performed, patients with space-occupying tumor bed cysts were identified and their hospital notes reviewed for relevant variables. Statistical analyses were performed and odds ratios (OR) with 95% confidence intervals (CI) calculated.
RESULTS: In a cohort of 282 patients, tumor bed cysts were found in 12 (4%). Main symptoms were raised intracranial pressure (N = 11), new focal deficits (N = 6) and pseudomeningocele (N = 3), presenting at a median interval of 19 days since last resection. Cysts were treated with cysto-peritoneal (N = 7) and ventriculoperitoneal shunts (N = 5), resulting in clinical benefit in 75%. Intraoperative opening of ventricles is a risk factor, with an odds ratio of 39.3390. We propose a classification with three cyst types (isolated cyst, cyst with local CSF disturbance, cyst with global CSF disturbance).
CONCLUSIONS: In modern neuro-oncology, the rate of tumor bed cysts complicating HGG management appears stable compared to historical data. Shunt implantation is feasible and effective. We propose a classification as a common data element for comparison across future studies.

PMID: 28512049 [PubMed - as supplied by publisher]

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