1Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea 2Neural Development and Anomaly Laboratory, Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Korea 3Department of Pathology, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea 4Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
Correspondence
Ji Hoon Phi ,Tel: 82-2-2072-3639, Fax: 82-2-744-8459, Email: phijh@snu.ac.kr
Received: October 31, 2023; Accepted: December 26, 2023. Published online: December 28, 2023.
ABSTRACT
Purpose
The present study aimed to evaluate the role of early and delayed surgery in congenital brain tumors and analyze the clinical outcomes of infantile brain tumors.
Materials and Methods
We performed a retrospective cohort study on 69 infantile brain tumors at a single institution from January 2008 to June 2023. Outcomes were assessed as early mortality (within 30 days following surgery) to evaluate the risk of early surgery in congenital brain tumors. Outcomes of recurrence and overall survival were analyzed in infantile brain tumors.
Results
Surgery-related early mortality appeared to occur in young and low-body-weight patients. Cut-off values of age and body weight were found to be 1.3 months and 5.2 kg to avoid early mortality. Three patients (3/10, 30%) showed early mortality in the early surgery group, and early mortality occurred in one patient (1/14, 7.14%) in the delayed surgery group, whose tumor was excessively enlarged. Younger age at diagnosis (< 3 months of age, HR: 7.1, 95% CI: 1.4 - 35.6, p=0.018) and leptomeningeal seeding (LMS, HR: 30.6, 95% CI: 3.7 - 253.1, p=0.002) were significant independent risk factors for high mortality in infantile brain tumors.
Conclusion
We suggest delaying surgery until the patient reaches 1.3 months of age and weighs over 5.2 kg with short-term imaging follow-up unless tumors grow rapidly in congenital brain tumors. Younger ages and the presence of LMS are independent risk factors for high mortality in infantile brain tumors.
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