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The role of imaging features and resection status in the survival outcome of sporadic optic pathway glioma children receiving different adjuvant treatments

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Abstract

Optic pathway glioma (OPG) is a rare brain tumor affecting children, with no standard treatment strategy. This study described the sporadic OPG survival outcomes after surgical treatment and analyzed the role of imaging features and resection status in children receiving different adjuvant treatments. This retrospective study included 165 OPG patients whose clinical information were obtained from the hospital record system. Tumor volume and residual tumor volume were calculated by delineating the lesion area. Kaplan–Meier method and Cox proportional hazards model were conducted to analyze the independent prognosis factor. A total of 165 patients were included in this study. Respectively, the 5-year overall survival (OS) and progression-free survival (PFS) were 87.58% and 77.87%. Residual tumor size and first adjuvant treatment (AT) after surgery were both associated with PFS. In patients with small-size residual tumors, there was no significant difference in PFS between the AT treatment groups. Moreover, age, exophytic cystic components, leptomeningeal metastases, and AT were associated with OS. In patients with exophytic cystic components and those with leptomeningeal metastases, there was no significant difference in OS. Our results revealed that OPG patients could avoid or defer AT by maximized resection. Age ≤ 2 years was a disadvantageous factor for OS. Patients with exophytic cystic components were more likely to benefit from primary surgery, and CT or RT was not beneficial for these patients. Patients with leptomeningeal metastases had a poor prognosis regardless of the treatment they received. Future prospective clinical studies are needed to develop more effective treatment regimens.

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Data availability

The processed data required to reproduce these findings cannot be shared at this time as they are part of an ongoing study.

Abbreviations

AT:

Adjuvant treatment

BMI:

Body mass index

CI:

Confidence interval

CT:

Chemotherapy

DA:

Diffuse astrocytoma

GTR:

Gross total resection

HR:

Hazard ratio

ICH:

Intracranial hypertension

LGG:

Low-grade glioma

LP:

Light perception

NLP:

No light perception

OB:

Observation

OPG:

Optic pathway glioma

OS:

Overall survival

PA:

Pilocytic astrocytoma

PA/PMXA:

Pilocytic astrocytoma with pilomyxoid features

PD:

Progressive disease

PFS:

Progression-free survival

PMXA:

Pilomyxoid astrocytoma

RT:

Radiotherapy

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Acknowledgements

We thank all the patients and their families for their cooperation during the follow-up.

Funding

Capital’s Funds for Health Improvement and Research (2020–2-2047).

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Author notes

  1. Zhiming Liu and Chihyi Liao contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China

    Zhi-ming Liu, Chi-hyi Liao, Xu An, Wen-tao Zhou, Zhen-yu Ma, Wei Liu & Yong-ji Tian

  2. Laboratory of Neural Reconstruction, Beijing Key Laboratory of Central Nervous System Injury, Beijing Neurosurgical Institute, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China

    Yong-ji Tian

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Contributions

Acquisition of data: ZL, CL, XA, WZ. Analysis and interpretation of data: ZL, CL, XA, WZ. Statistical analysis: ZL, CL. Drafting the article: ZL, CL. Critically revising the article: ZL, C, XA, WZ, ZM, WL, YT. Funding acquisition: YT. Conception and design: ZL, CL, ZM, WL, YT. Study supervision: ZL, CL, ZM, WL, YT.

Corresponding author

Correspondence to Yong-ji Tian.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants with the ethical standards of the institutional and/or national research committee by the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was reviewed and approved by the Institutional Review Board of Beijing Tiantan Hospital, Capital Medical University (KY 2020–054-04).

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Legal guardians of all study participants provided informed written consent to participate.

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All individual case information was removed. The data was analyzed retrospectively after obtaining informed consent from legal guardians of all study participants.

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The authors declare no competing interests.

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Supplementary information

Below is the link to the electronic supplementary material.

Supplementary Fig. S1.

A treatment course of included patients with sporadic optic pathway glioma. (PNG 786 kb)

High resolution image (TIF 4448 kb)

Supplementary Fig. S2.

The progression-free survival (PFS) and overall survival (OS) of all participants. (PNG 81 kb)

High resolution image (TIF 10271 kb)

Supplementary Tables S1–S5

(DOCX 31 kb)

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Liu, Zm., Liao, Ch., An, X. et al. The role of imaging features and resection status in the survival outcome of sporadic optic pathway glioma children receiving different adjuvant treatments. Neurosurg Rev 45, 2277–2287 (2022). https://doi.org/10.1007/s10143-022-01743-1

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