Related Experiment Video
Updated: Sep 2, 2025
A Protocol for Rapid Post-mortem Cell Culture of Diffuse Intrinsic Pontine Glioma DIPG
Published on: March 7, 2017
Treatment Limitations for Pediatric Diffuse Intrinsic Pontine Gliomas in a Middle-Income Country
Pablo E Baquero-Herrera1, Manuel A Ardila-Martínez1,2, Nadín J Abdalá-Vargas1,2
1Department of Neurosurgery, Hospital Infantil Universitario de San José, Fundacion Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
Insights
Surgical outcomes for pediatric diffuse intrinsic pontine gliomas (DIPG) in a middle-income country showed decreased survival. Social, geographic, and economic barriers significantly impacted patient outcomes, necessitating further investigation.
Area of Science:
- Pediatric neurosurgery
- Neuro-oncology
- Global health disparities in cancer care
Background:
- Diffuse intrinsic pontine gliomas (DIPGs) are aggressive brain tumors in children.
- Surgical management of DIPGs is challenging, especially in resource-limited settings.
- Understanding outcomes and barriers is crucial for improving care.
Purpose of the Study:
- To assess surgical outcomes for pediatric DIPG patients undergoing biopsy or partial resection.
- To identify challenges and barriers in a middle-income country context.
- To compare outcomes with international data.
Main Methods:
- Retrospective review of a prospective series of pediatric DIPG patients (2012-2018).
- Inclusion criteria: biopsy or partial resection for DIPG.
- Data collected: patient demographics, tumor type, surgical procedures, and functional status (Lansky Play-Performance Scale).
Main Results:
- Seven pediatric DIPG cases were analyzed (median age 5 years).
- Five patients (71.4%) underwent partial resection; two (28.6%) had biopsy.
- Postoperative functional status significantly declined (median LPPS 23 vs. 80 preoperatively).
Conclusions:
- Pediatric DIPG surgical management in this setting resulted in lower overall survival compared to other series.
- Social, geographic, and economic factors present significant barriers to optimal care and outcomes.
- Further research is needed to address these multifactorial challenges.
Abstract:
Objectives To evaluate the surgical management outcomes in pediatric patients with diffuse intrinsic pontine gliomas (DIPGs) who underwent intended biopsies and partial resections in a middle-income country, highlighting the barriers and challenges of these procedures for further investigation. Methods A retrospective review of a prospective acquired series of patients who underwent biopsy or resection for DIPG between January 2012 and June 2018 at our institution was performed. Results A total of 43 patients with posterior fossa tumors were identified. From these, seven pediatric DIPG cases were enrolled. Five were males. The median age was 5 years (range: 1-12 years). Only one patient (14.3%) had a ganglioglioma, while the others presented pilocytic and diffuse astrocytomas. Two (28.6%) patients had an intentional biopsy, and the other five (71.4%) had a partial resection. In the three (28.6%) patients who presented with associated hydrocephalus, the endoscopic third ventriculostomy was performed in the same surgical time. The median preoperative Lansky play-performance scale (LPPS) was 80 (range: 60-100), while the median postoperative LPPS was 23 (range: 7-52). Conclusion A decrease in overall survival was noted compared with data reported in other series. Multifactorial barriers were discussed including the social, geographic, and economic features that may influence on final outcomes.
