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Updated: Jul 16, 2025
Longitudinal Intravital Imaging of Brain Tumor Cell Behavior in Response to an Invasive Surgical Biopsy
Published on: May 3, 2019
Neurosurgical treatment of pediatric brain tumors - results from a single center multidisciplinary setup
A Schaumann1, C Hammar1, S Alsleben1
1Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Pediatric Neurosurgery, Augustenburger Platz 1, 13353, Berlin, Germany.
Insights
This study reviewed pediatric brain tumor surgeries, highlighting the need for multidisciplinary expertise to manage diverse cases and improve outcomes for long-term survival.
Area of Science:
- Pediatric Neurosurgery
- Neuro-oncology
- Tumor Biology
Background:
- Pediatric brain tumor surgery presents unique challenges due to patient age, tumor location, and pathological heterogeneity.
- Multidisciplinary decision-making and national treatment protocols are crucial for improving long-term survival rates.
Purpose of the Study:
- To review the spectrum of pediatric brain tumor surgeries from the perspective of an interdisciplinary neuro-oncology center.
- To define challenges and develop quality indicators for pediatric neuro-oncological surgery.
Main Methods:
- Retrospective evaluation of pediatric patients undergoing brain tumor surgery between January 2010 and June 2017.
- Analysis of perioperative data including tumor characteristics, surgical interventions, oncologic therapy, and neurological follow-up.
Main Results:
- 293 pediatric patients underwent 531 surgical interventions; glial and embryonal tumors were most frequent.
- High rates of planned resection (92.7%) were achieved, with significant resolution or regression of neurological deficits.
- A low mortality rate of 1% was observed, with new deficits resolving or improving in 80% of cases within 30 days.
Conclusions:
- Pediatric neuro-oncology centers require high multidisciplinary expertise to address case heterogeneity.
- Adequate patient volume and interdisciplinary infrastructure are essential for effective treatment and improved quality of life for pediatric brain tumor survivors.
Objective:
The challenge of pediatric brain tumor surgery is given due to a relative low prevalence but high heterogeneity in age, localization, and pathology. Improvements of long-term overall survival rates were achieved during the past decades stressing the importance of a multidisciplinary decision process guided by a national treatment protocol. We reviewed the entire spectrum of pediatric brain tumor surgeries from the perspective of an interdisciplinary pediatric neuro-oncology center in Germany.
Methods:
Every patient who underwent brain tumor surgery from January 2010 to June 2017 in our Pediatric Neurosurgery department was retrospectively included and evaluated regarding the course of treatment. Perioperative data such as tumor localization, timing of surgery, extent of resection, neuropathological diagnosis, transfusion rates, oncologic and radiation therapy, and neurological follow-up including morbidity and mortality were evaluated.
Results:
Two hundred ninety-three pediatric brain tumor patients were applicable (age: 8.28 ± 5.62 years, 1.22:1.0 m:f). A total of 531 tumor surgical interventions was performed within these patients (457 tumor resections, 74 tumor biopsies; mean interventions per patient 1.8 ± 1.2). Due to a critical neurologic status, 32 operations (6%) were performed on the day of admission. In 65.2% of all cases, tumor were approached supratentorially. Most frequent diagnoses of the cases were glial tumors (47.8%) and embryonal tumors (17.6%). Preoperative planned extent of resection was achieved in 92.7%. Pre- and postoperative neurologic deficits resolved completely in 30.7%, whereas symptom regressed in 28.6% of surgical interventions. New postoperative neurologic deficit was observed in 10.7%, which resolved or improved in 80% of these cases during 30 days. The mortality rate was 1%.
Conclusion:
We outlined the center perspective of a specialized pediatric neuro-oncological center describing the heterogeneous distribution of cases regarding age-related prevalence, tumor localization, and biology, which requires a high multidisciplinary expertise. The study contributes to define challenges in treating pediatric brain tumors and to develop quality indicators for pediatric neuro-oncological surgery. We assume that an adequate volume load of patients within a interdisciplinary infrastructure is warranted to aim for effective treatment and decent quality of life for the majority of long-term surviving pediatric tumor patients.
