Long-term outcomes of ventricular entry in high grade glioma resection: A meta-Analysis and meta regression

Area of Science:

• Neuro-oncology
• Neurosurgery
• Clinical Epidemiology

Background:

• Ventricular entry (VE) during high-grade glioma (HGG) treatment is suspected to worsen patient prognosis.
• The precise impact of VE on HGG outcomes, including specific adverse events and survival, requires systematic evaluation.

Purpose of the Study:

• To systematically evaluate the association between ventricular entry and adverse events in patients with high-grade gliomas.
• To analyze the impact of VE on leptomeningeal dissemination (LMD), distant parenchymal recurrence (DPR), hydrocephalus, and overall survival.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed, Scopus, etc.) for longitudinal studies up to June 2025.
• Seventeen studies involving 4,086 participants were included, with primary outcomes being LMD, DPR, and hydrocephalus.
• Survival analysis (Kaplan-Meier) and meta-regression were employed to assess survival patterns and identify heterogeneity factors.

Main Results:

• Ventricular entry was significantly associated with increased risks of LMD (RR 2.23) and hydrocephalus (RR 3.57).
• No significant association was found between VE and distant parenchymal recurrence (DPR) in the overall analysis.
• VE was linked to increased mortality (HR 1.12) up to 84 months; meta-regression identified factors influencing LMD, DPR, and hydrocephalus.

Conclusions:

• Ventricular entry in high-grade gliomas appears to be associated with a higher risk of leptomeningeal dissemination and hydrocephalus.
• The findings suggest a potential negative impact of VE on overall survival in HGG patients.
• These associations require further investigation, and the current findings should be considered provisional.