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Choroid Plexus Papillomas: A Single
Institutional Experience
Sunil Krishnan, Paul D. Brown, Bernd W. Scheithauer,
Michael J. Ebersold, Julie E. Hammack, Jan C. Buckner
Division
of Radiation Oncology (S.K.,
P.D.B.) , Division of Anatomic Pathology (B.W.S.),
Department of Neurologic Surgery (M.J.E.),
Division of Neuro-Oncology (J.E.H.),
Division of Medical Oncology (J.C.B), Mayo Clinic, Rochester, Minnesota, USA
Objective.
To determine the long-term outcome of resected choroid plexus papillomas (CPPs).
Methods. Medical records and histologic specimens were
reviewed for 41 patients (19 male, 22 female; median age, 36 years; range, 6
months to 74 years) with CPP seen between 1974 and 2000.
Tumor locations were as follows: 76%, fourth ventricle; 17%, lateral ventricle,
and 7%, third ventricle.
Fifty-six percent had a gross total resection (GTR) and 44% had a subtotal
resection (STR).
Median follow-up was 6.5 years.
Results. Five-year local control, distant brain control,
and overall survival were 84%, 92%, and 97%, respectively.
Comparison of GTR and STR at 5 years showed a significant increase in local
control (100% vs. 68%; P = 0.04) but not in overall survival (100% vs.
94%).
Even after STR, only 50% of patients required a subsequent resection for
recurrence.
Addition of radiation therapy to initial STR did not seem to influence
outcomes.
At first relapse, GTR was accomplished in 1 patient, and only STR was
accomplished in the others.
Addition of radiation therapy to STR in our study led to disease control in half
the patients treated, and STR alone led to disease control in only a quarter of
the patients.
Second relapses were treated palliatively with radiation therapy.
Conclusions.
Surgical resection is the treatment of choice for CPPs.
After initial STR, reoperations for recurrence are required only half the
time.
Therefore, there seems to be no role for radiation therapy after initial
STR.
For STRs at first relapse, local control outcome is poor.
Keywords: choroid plexus papilloma, radiation therapy, surgery
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source: http://journals.kluweronline.com/article.asp?PIPS=5268434
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