Role of available adjuvant therapies following surgical resection of atypical choroid plexus papilloma—a systematic review and pooled analysis

Abstract

Background Atypical choroid plexus papilloma is a recently introduced entity with intermediate pathological characteristics. These tumors are relatively rare and the optimal management of these tumors is a matter of debate. Therefore, we performed a systematic review and pooled analysis about the effects of adjuvant therapies upon outcome measures of these patients. We also compared these effects upon totally and partially resected tumors and pediatric and adult populations. Methods A systematic search of three databases based on inclusion/exclusion criteria was performed. Data extraction was separately performed by two authors, and the summarized data were presented in the form of tables. Pooled estimates of different outcome measures were calculated for each adjuvant therapy and presented separately for studies with pediatric, adult, or mixed populations. Results A review of 14 included studies consisting of 144 patients revealed the effect of adjuvant treatment on reduction of tumor recurrence, metastasis, and reoperation rates and increasing survival rates in patients with subtotal tumor resection. This advantage was not seen in the case of gross total tumor resection. Almost all outcome measures were more favorable in the pediatric population. Conclusions It can be concluded that whenever gross total resection is not feasible, the implementation of adjuvant therapy can improve the outcome and prognosis. In other cases, it should be decided on an individual basis. Also, more aggressive behavior and higher rates of recurrence and mortality in the adult population suggests the consideration of more aggressive adjuvant treatments for adult patients.

Final results of the Choroid Plexus Tumor study CPT-SIOP-2000

“…Furthermore, particularly in the context of LFS, second malignancies remain a concern. A recent literature review was inconclusive with respect to specific indications for chemotherapy and radiotherapy [13]. Establishing a treatment algorithm as guidance was a major objective of the CPT-SIOP-2000 study, and the algorithm developed was widely followed in the international pediatric neuro-oncology community.…”

“…Furthermore, particularly in the context of LFS, second malignancies remain a concern. A recent literature review was inconclusive with respect to specific indications for chemotherapy and radiotherapy [ 13 ].…”

“…Treatment recommendations for CPT include multidisciplinary approaches, with maximal surgical resection for all CPT [8][9][10][11][12][13][14], followed by chemotherapy [11,[15][16][17][18][19][20][21] and radiotherapy [22][23][24] for high-risk CPT. The prognosis of CPC remains dismal when tumor resection is the only treatment modality, and the role, sequence, and intensity of primary chemotherapy remain debatable [13,19,21].…”

Metastatic choroid plexus papilloma presenting as a sellar mass: A case report and literature review

“…Chemotherapy, particularly in cases of CPC, has been reported to increase overall survival. [ 18 ] Although data regarding specific dosing regimens is largely lacking, etoposide, vincristine, cisplatin, cyclophosphamide, carboplatin, or ifosfamide are most commonly utilized. In a randomized trial, Wolff et al .…”

Bilateral Choroid Plexus Papillomas Diagnosed by Prenatal Ultrasound and MRI

“…Previously published survival rates for perinatal atypical choroid plexus papilloma is 67%, which is intermediate between 81% for choroid plexus papilloma and 45% for choroid plexus carcinoma [ 2 ]. If patients survive the neonatal period, the treatment regimen for this tumor typically involves surgical resection, and when indicated and feasible, may also include adjuvant or neoadjuvant chemotherapy, and/or preoperative embolization, to reduce tumor size and vascularity [ 13 , 14 ]. Radiation is not typically used in the neonatal population due to long-term deleterious effects on developing tissue [ 2 ].…”