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. 2010 Nov;26(11):1583-92.
doi: 10.1007/s00381-010-1086-1. Epub 2010 Mar 5.

Surgical morbidity and mortality of pediatric brain tumors: a single center audit

F W Neervoort  1 , W J R Van Ouwerkerk, H Folkersma, G J L Kaspers, W P Vandertop
Affiliations

Surgical morbidity and mortality of pediatric brain tumors: a single center audit

F W Neervoort et al. Childs Nerv Syst. 2010 Nov.

Abstract

Objectives: The primary aim of this study is to perform an internal quality control of pediatric brain tumor surgery in the neurosurgical department of the VU University Medical Center Amsterdam (The Netherlands). Secondly, this study aims to contribute to the accumulating data concerning outcome in pediatric neurosurgery, in order to establish institutional practice benchmarks.

Methods: We report the surgical mortality and morbidity of 121 patients (0-18 years) surgically treated for a brain tumor from January 1999 to August 2007. Patients, in whom only a brain tumor biopsy was performed, were excluded.

Results: Mean age at first surgery was 8.2 years. Of the 121 patients, 14 had a second surgery, and two underwent a third surgery (for a total of 137 operations). Of all 121 primary surgeries, 66% were total resections, 26% subtotal resections, and 8% partial resections. The overall surgical morbidity rate in this study was 69% after first surgery, 50% after second surgery, and one out of two after third surgery.

Conclusion: These overall morbidity rates are comparable to other published mixed case series. The surgical mortality rate was 0.8%; this is comparable to the lowest rates reported for high-volume neurosurgical centers. We encourage other neurosurgical centers to collect, analyze, and publish their data. These data can then serve as a basis for comparison with other pediatric neurosurgical centers and will eventually lead to an improvement of pediatric neurosurgical practice and patient care.

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Figures

Fig. 1
Fig. 1
Age distribution at presentation of children with a brain tumor (N = 121; mean age = 8.2 years)
Fig. 2
Fig. 2
Specification and number of neurological complications after first surgery. ICP intracranial pressure
Fig. 3
Fig. 3
Specification, number, and tumor location of short-term endocrinological complications after first surgery
Fig. 4
Fig. 4
Specification, number, and tumor location of long-term endocrinological complications after first surgery
Fig. 5
Fig. 5
Specification and number of neurological complications after second surgery
Fig. 6
Fig. 6
Total cumulative survival
Fig. 7
Fig. 7
Cumulative survival according to the WHO classification
Fig. 8
Fig. 8
Cumulative survival of patients according to the extent of tumor resection
See this image and copyright information in PMC

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