Universität zu Köln

Hamisch, Christina, Kickingereder, Philipp, Fischer, Matthias, Simon, Thorsten and Ruge, Maximilian I. (2017). Update on the diagnostic value and safety of stereotactic biopsy for pediatric brainstem tumors: a systematic review and meta-analysis of 735 cases. J. Neurosurg.-Pediatr., 20 (3). S. 261 - 269. ROLLING MEADOWS: AMER ASSOC NEUROLOGICAL SURGEONS. ISSN 1933-0715

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Abstract

OBJECTIVE Recent studies have shed light on the molecular makeup of diffuse intrinsic pontine gliomas and led to the identification of potential treatment targets for these lesions, which account for the majority of pediatric brainstem tumors (pedBSTs). Therefore, stereotactic biopsy driven molecular characterization of pedBSTs may become an important prerequisite for the management of these fatal brain tumors. The authors conducted a systemic review and meta-analysis to precisely determine the safety and diagnostic success of stereotactic biopsy of pedBSTs. METHODS A systematic search of PubMed, EMBASE, and the Web of Science yielded 944 potentially eligible abstracts. Meta-analysis was conducted on 18 studies (including the authors' own institutional series), describing a total of 735 biopsy procedures for pedBSTs. The primary outcome measures were diagnostic success and procedure-related complications. Pooled estimates were calculated based on the Freeman-Tukey double-arcsine transformation and DerSimonian-Laird random-effects model. Heterogeneity, sensitivity, and meta-regression analyses were also conducted. RESULTS The weighted average proportions across the analyzed studies were 96.1% (95% CI 93.5%-98.1%) for diagnostic success, 6.7% (95% CI 4.2%-9.6%) for overall morbidity, 0.6% (95% CI 0.2%-1.4%) for permanent morbidity, and 0.6% (95% CI 0.2%-1.3%) for mortality. Subgroup analyses at the study level identified no significant correlation between the outcome measures and the distribution of the chosen biopsy trajectories (transfrontal vs transcerebellar), age, year of publication, or the number of biopsy procedures annually performed in each center. CONCLUSION Stereotactic biopsy of pedBSTs is safe and allows successful tissue sampling as a prerequisite for the molecular characterization and the identification of potentially druggable targets toward more individualized treatment concepts to improve the outcome for children harboring such lesions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hamisch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kickingereder, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Simon, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian I. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-220940
DOI:	10.3171/2017.2.PEDS1665
Journal or Publication Title:	J. Neurosurg.-Pediatr.
Volume:	20
Number:	3
Page Range:	S. 261 - 269
Date:	2017
Publisher:	AMER ASSOC NEUROLOGICAL SURGEONS
Place of Publication:	ROLLING MEADOWS
ISSN:	1933-0715
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LESIONS; CHILDREN; GLIOMA; TRANSCEREBELLAR; SERIES; MASSES; ADULTS Multiple languages Clinical Neurology; Pediatrics; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22094