• World Neurosurg · Jan 2024

    Meta Analysis

    Management of Atypical Teratoid/Rhabdoid Tumors in the Pediatric Population: A Systematic Review and Meta-Analysis.

    • Nithin K Gupta, Nikhil Godbole, Praveen Sanmugananthan, Saket Gunda, Varun Kasula, Mia Baggett, Avi Gajjar, KouamRomaric WaguiaRWDepartment of Neurosurgery, Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA., Randy D'Amico, and Shaun Rodgers.
    • Department of Neurosurgery, Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA. Electronic address: n_gupta0210@email.campbell.edu.
    • World Neurosurg. 2024 Jan 1; 181: e504e515e504-e515.

    BackgroundAtypical teratoid/rhabdoid tumors are rare and aggressive tumors that mainly affect children <3 years of age. Despite aggressive treatment, the overall survival rate for pediatric atypical teratoid/rhabdoid tumors remains poor. Due to their rarity, little is known regarding prognostic factors, and there is no official standard of treatment.MethodsA comprehensive database search was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search terms included "atypical teratoid rhabdoid tumor" and "atypical (teratoid OR rhabdoid) tumor." Variables of interest included, but were not limited to, age, sex, tumor location, treatment modality, extent of resection, and overall survival.ResultsThe study included 294 articles and 936 patients. The median age of patients was 22 months. There was a significant difference in survival among patients receiving surgery compared with patients receiving nonoperative treatment (50.3 months vs. 28 months; P < 0.005). Extent of resection did not significantly improve survival (P = 0.832 for gross total resection, P = 0.650 for partial resection). Combination therapy with surgical resection, radiotherapy, and chemotherapy demonstrated the largest median overall survival (54.9 months) and significantly improved survival on multivariate analysis (hazard ratio, 0.48; 95% confidence interval, 0.23-0.97; P = 0.042).ConclusionsThe results of this study indicate that while surgery is a crucial treatment modality for pediatric atypical teratoid/rhabdoid tumors, the effect of extent of resection is unclear. Multimodal therapy including surgery, radiotherapy, and chemotherapy is effective in improving overall survival. Future studies should focus on using larger datasets to efficiently account for confounding factors and biases.Copyright © 2023 Elsevier Inc. All rights reserved.

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