Introduction: Choroid plexus tumors(CPT) primarily affect pediatric patients and are surgically treated. However, the benefit of surgical resection is yet to be explored on a population-based scale. We aim to use SEER data to characterize the survival benefit of surgical resection in CPT patients.
Methods: We utilized the latest submission of SEER database(2015 submission). Patients diagnosed with choroid plexus tumors (ICD-O-3:9390) between 1973-2013 were identified in the SEER registry. We included both benign and malignant tumors in the study. Demographic information including age at diagnosis, sex, race, insurance status and marital status was collected. Baseline variables were compared between patients who were deceased and alive at last follow up. Multivariable Cox regression was used to determine impact on survival for surgical resection while adjusting for confounding variables.
Results: A total of 538 patients were included in this cohort, with 430(79.9%) remaining alive at last follow-up. Age at diagnosis was 24.2 years with 50% female. Multivariable analysis suggested that older age(HR:1.02, p < 0.001) and male gender(HR:1.68, p = 0.010) were significantly associated with poor survival. Furthermore, larger tumor size(size>40mm, HR:3.80, p < 0.001) and higher WHO grade(HR:9.50, p=0.010 for grade 2, HR:19.47, p<0.001 for grade 3) also portended a worse outcome. Those who underwent surgical resection fared better than those who did not(p=0.001), and GTR/TR(HR:0.41) sustained only a slightly better outcome than partial resection(HR:0.30). Post-operative radiation therapy did not significantly affect survival outcomes(HR:1.64, p=0.120).
Conclusions: Older age, male gender, larger tumor size, and higher WHO grade were correlated with poor survival in patients with choroid plexus tumors. Both partial resection and GTR has significant survival benefit compared to no surgery. No survival benefit of post-operative radiation therapy has been affirmed in this study.
Patient Care: Based on the study results, surgical resection should be recommended for patients with CPT. The identification of numerous predictors of survival will be helpful in improving individualization of treatment for CPT patients
Learning Objectives: By the conclusion of this session, participants should be able to:
1. Appreciate the factors associated with poor survival in patients with CPT.
2. Understand the effect of aggressive surgical resection on CPT survival outcomes.
3. Evaluate the role of radiation therapy in the treatment of CPT.