Evaluation of the ETV success score to improve decision making on the management of hydrocephalus secondary to pediatric posterior fossa tumors: A feasibility study

Leopoldo Mandic Furtado, José Aloysio Da Costa Val Filho, Aieska Kellen Dantas dos Santos, Jaime Xavier De Oliveira Neto, Márcio Júnior Pena, Cristiano Frattesi Bernardes, Mariana Gonçalves Lima de Paula, Anne Ribeiro Magalhães, Alice Izabel Costa Silva
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 Objective: This study aims to evaluate the efficacy of ETV in the treatment of hydrocephalus related to PFT and to evaluate the accuracy of the ETV success score in predicting ETV success.
 Methods: Patients under 18 years of age who underwent ETV before PFT resection between 1996 and 2021 were included in a retrospective study. The ETV success score was retrospectively obtained for all patients, and its predictive capacity was compared to the actual success observed.
 Results: Of the 59 surgical cases, a global success rate of 62.7% was observed in the first 6 months following ETV. This rate dropped to 50.8% for those patients reassessed one year after surgery. There was no correlation between the success rate and the histological grade of the tumor or the age of the patient. The ETV success score presented acceptable accuracy at both time points (AUC = 0.671 at 6 months, AUC = 0.649 at one year).
 Conclusion: ETV proved be a safe procedure, capable of treating hydrocephalus in patients with PFT, and the ETV success score is useful for indicating probable success of the endoscopic procedure.","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"16 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Pediatric Neurosurgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.46900/apn.v5i3.200","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Hydrocephalus is frequently seen in children with posterior fossa tumors (PFT), and endoscopic third ventriculostomy (ETV) prior to tumor resection can improve surgical conditions by treating the hydrocephalus. Moreover, a scoring system predicting the success of ETV could aid in decision-making for this procedure. Objective: This study aims to evaluate the efficacy of ETV in the treatment of hydrocephalus related to PFT and to evaluate the accuracy of the ETV success score in predicting ETV success. Methods: Patients under 18 years of age who underwent ETV before PFT resection between 1996 and 2021 were included in a retrospective study. The ETV success score was retrospectively obtained for all patients, and its predictive capacity was compared to the actual success observed. Results: Of the 59 surgical cases, a global success rate of 62.7% was observed in the first 6 months following ETV. This rate dropped to 50.8% for those patients reassessed one year after surgery. There was no correlation between the success rate and the histological grade of the tumor or the age of the patient. The ETV success score presented acceptable accuracy at both time points (AUC = 0.671 at 6 months, AUC = 0.649 at one year). Conclusion: ETV proved be a safe procedure, capable of treating hydrocephalus in patients with PFT, and the ETV success score is useful for indicating probable success of the endoscopic procedure.
评价ETV成功评分提高小儿后窝肿瘤继发脑积水治疗决策的可行性研究
脑积水常见于后颅窝肿瘤(PFT)患儿,肿瘤切除前行内镜下第三脑室造口术(ETV)可通过治疗脑积水改善手术条件。此外,预测ETV成功的评分系统可以帮助该手术的决策。 目的:本研究旨在评价ETV治疗PFT相关性脑积水的疗效,并评价ETV成功评分预测ETV成功的准确性。方法:回顾性研究纳入1996年至2021年间在PFT切除术前接受ETV的18岁以下患者。回顾性获得所有患者的ETV成功评分,并将其预测能力与观察到的实际成功进行比较。 结果:59例手术中,ETV术后6个月的总体成功率为62.7%。对于术后一年重新评估的患者,这一比例降至50.8%。成功率与肿瘤的组织学分级或患者的年龄没有相关性。ETV成功评分在两个时间点均具有可接受的准确性(6个月时AUC = 0.671, 1年时AUC = 0.649)。 结论:ETV被证明是一种安全的手术,能够治疗PFT患者的脑积水,ETV成功评分可用于指示内镜手术成功的可能性。
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