Previous studies have shown a shorter survival after diagnosis of leptomeningeal dissemination in glioblastoma (GBM) patients. The contribution of ventricular entry during surgical excision to leptomeningeal dissemination was already speculated.
This retrospective study analyzed 200 cases. The GBM localization was periventricular in 69.5% of cases, and there was a ventricular entry during the surgical procedure in 51% of cases. The risk of post-surgical leptomeningeal dissemination in the case of ventricular entry was 16%. The rate of leptomeningeal dissemination was higher in the case of ventricular entry than in cases (27.4% vs. 4%, p < 0.0001). On the other hand, the rate of leptomeningeal dissemination in periventricular GBM was 19% (p = 0.1131).
According to this paper, ventricular opening is an independent factor associated with a higher rate of post-surgical leptomeningeal dissemination, and the periventricular localization only is not independently correlated to this negative outcome.
Neurosurgeons should avoid ventricular entry when possible. The correct surgical strategy should be founded on balancing the need for maximal extent of resection and the risks associated with ventricular entry.
Maíra Cristina Velho is a Neurosurgeon from Nossa Senhora das Graças Hospital and
2nd treasurer of SNOLA.
Article link: https://doi.org/10.1007/s11060-022-04166-6