Neurosurgical short-term outcomes for pediatric medulloblastoma patients and molecular correlations: a 10-year single-center observation cohort study

作者全名：Zhang, Zaiyu; Wu, Yuxin; Zhao, Xueling; Ji, Wenyuan; Li, Lusheng; Zhai, Xuan; Liang, Ping; Cheng, Yuan; Zhou, Jianjun

作者地址：[Zhang, Zaiyu; Wu, Yuxin; Zhao, Xueling; Ji, Wenyuan; Li, Lusheng; Zhai, Xuan; Liang, Ping; Zhou, Jianjun] Chongqing Med Univ, Dept Neurosurg, Childrens Hosp, Chongqing, Peoples R China; [Zhang, Zaiyu; Wu, Yuxin; Zhao, Xueling; Ji, Wenyuan; Li, Lusheng; Zhai, Xuan; Liang, Ping; Zhou, Jianjun] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China; [Zhang, Zaiyu; Wu, Yuxin; Zhao, Xueling; Ji, Wenyuan; Li, Lusheng; Zhai, Xuan; Liang, Ping; Zhou, Jianjun] Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Zhang, Zaiyu; Wu, Yuxin; Zhao, Xueling; Ji, Wenyuan; Li, Lusheng; Zhai, Xuan; Liang, Ping; Zhou, Jianjun] Chongqing Key Lab Child Neurodev & Cognit Disorder, Chongqing, Peoples R China; [Cheng, Yuan] Chongqing Med Univ, Affiliated Hosp 2, Dept Neurosurg, Chongqing, Peoples R China

通信作者：Zhou, JJ (通讯作者)，Chongqing Med Univ, Dept Neurosurg, Childrens Hosp, Chongqing, Peoples R China.; Zhou, JJ (通讯作者)，Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China.; Zhou, JJ (通讯作者)，Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China.; Zhou, JJ (通讯作者)，Chongqing Key Lab Child Neurodev & Cognit Disorder, Chongqing, Peoples R China.

来源：NEUROSURGICAL REVIEW

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001252385800003

JCR分区：Q1

影响因子：2.5

年份：2024

卷号：47

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Medulloblastoma; Molecular subgroup; Pediatric; Short-term outcome; Quality indicator; Operative complications

摘要：This study examined the risk factors for short-term outcomes, focusing particularly on the associations among molecular subgroups. The analysis focused on the data of pediatric patients with medulloblastoma between 2013 and 2023, as well as operative complications, length of stay from surgery to adjuvant treatment, 30-day unplanned reoperation, unplanned readmission, and mortality. 148 patients were included. Patients with the SHH TP53-wildtype exhibited a lower incidence of complications (45.2% vs. 66.0%, odds ratio [OR] 0.358, 95% confidence interval [CI] 0.160 - 0.802). Female sex (0.437, 0.207 - 0.919) was identified as an independent protective factor for complications, and brainstem involvement (1.900, 1.297 - 2.784) was identified as a risk factor. Surgical time was associated with an increased risk of complications (1.004, 1.001 - 1.008), duration of hospitalization (1.006, 1.003 - 1.010), and reoperation (1.003, 1.001 - 1.006). Age was found to be a predictor of improved outcomes, as each additional year was associated with a 14.1% decrease in the likelihood of experiencing a prolonged length of stay (0.859, 0.772 - 0.956). Patients without metastasis exhibited a reduced risk of reoperation (0.322, 0.133 - 0.784) and readmission (0.208, 0.074 - 0.581). There is a significant degree of variability in the occurrence of operative complications in pediatric patients with medulloblastoma. SHH TP53-wildtype medulloblastoma is commonly correlated with a decreased incidence of complications. The short-term outcomes of patients are influenced by various unmodifiable endogenous factors. These findings could enhance the knowledge of onconeurosurgeons and alleviate the challenges associated with patient/parent education through personalized risk communication. However, the importance of a dedicated center with expertise surgical team and experienced neurosurgeon in improving neurosurgical outcomes appears self-evident.

基金机构：　

基金资助正文：