Impact of surgery, adjuvant therapy and other prognostic factors for choroid plexus carcinoma; a systematic review and individual patient data analysis

Publication date: Available online 18 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Supriya Mallick, Rony Benson, Wineeta Melgandi, G.K. Rath
ObjectiveThe optimal management of patients with choroid plexus carcinoma (CPC) is unclear. We conducted a systematic review and meta-analysis of individual patient information to find the impact of surgery, adjuvant therapy and other prognostic factors in this disease.MethodologyA comprehensive search of the PubMed and Google scholar was performed with the following MesH terms: "choroid plexus tumor; choroid plexus carcinoma; choroid plexus carcinoma AND treatment; and choroid plexus carcinoma AND survival" to find all possible publications on CPC. We performed individual patient data analysis, to assess the strength of potential association between different variables and the outcome in patients with CPC.ResultsData from 284 patients was retrieved from 89 publications. The median age of the patients was 2 years with 26% patients diagnosed in the 1st year of their life. 52.8% of patients underwent a gross total resection [GTR] or near total resection. Median follow-up for the entire cohort was 10.8 months. Median progression free survival [PFS] was 13 months [95% CI 8.14-17.8]. PFS was better for patients older than 5 years and GTR. Median overall survival [OS] was 29 months (95% CI 16.3- 41.7). OS was better for patients older than 5 years, GTR, adjuvant treatment and parenchymal site of the tumor.ConclusionCPC is an aggressive tumor, with a median PFS of 13 months and a median OS of 29 months. All patients should undergo a maximal safe resection as GTR is associated with improved survival. Adjuvant radiation and chemotherapy were also associated with improved outcomes.

Teaser

Optimal management of patients with choroid plexus carcinoma (CPC) is not clear. We conducted a systematic review and meta-analysis of individual patient observations to find the impact of surgery, adjuvant therapy and other prognostic factors for CPC. Median overall survival for the entire cohort was 29 months. The overall survival was better for patients older than 5 years, patients undergoing GTR, adjuvant treatment, and parenchymal tumor. A gross total resection and adjuvant treatment need to be advocated for all patients as it improves survival outcome.


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