Neurosurgery for Optic Pathway Glioma: Optimizing Multidisciplinary Management.

Area of Science:

• Pediatric neuro-oncology
• Neuroscience
• Genetics

Background:

• Optic pathway gliomas (OPGs) represent 10% of pediatric brain tumors and 40% of pediatric low-grade gliomas (pLGGs).
• Historically, tissue diagnosis was often omitted due to clinical presentation, surgical risks, and effective chemotherapy.
• The delicate location and surgical challenges have made intervention strategies a long-standing debate.

Purpose of the Study:

• To highlight the evolving role of molecular characterization in managing pediatric OPGs.
• To emphasize the importance of a multidisciplinary approach for long-term patient care.
• To underscore the shift towards personalized medicine in neuro-oncology.

Main Methods:

• Review of current literature on OPG management and molecular profiling.
• Analysis of the impact of genetic drivers on treatment decisions.
• Discussion of the integration of molecular data into clinical practice.

Main Results:

• Advances in understanding genetic drivers are transforming OPG management.
• Operative tissue sampling is increasingly critical, particularly for non-NF1 patients.
• Molecular profiling offers new avenues for targeted therapies and prognostication.

Conclusions:

• A multidisciplinary approach is essential for the complex, long-term care of pediatric OPGs.
• Molecular characterization is becoming a cornerstone of OPG management, enabling tailored treatment.
• Integrating genetic insights promises improved outcomes for children with OPGs.