• World Neurosurg · Feb 2025

    Effects of surgical ventricular entry on gliomas invading the thalamus: clinical outcomes and economic burdens.

    • Jian Huang, Hao-Yi Li, Peng Xu, Xiao-Hui Ren, and Song Lin.
    • Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery, Linyi Central Hospital, Linyi, China.
    • World Neurosurg. 2025 Feb 8: 123731123731.

    BackgroundSurgical resection in gliomas invading the thalamus poses significant challenges due to the deep location and its localization near the ventricle. Ventricular entry (VE) during such operation is somewhat inevitable. However, the impact of VE on clinical outcomes is unclear. Additionally, it is unknown whether VE is associated with increased medical costs.MethodsThis retrospective study was conducted in Beijing Tiantan hospital from Jan. 2013 to Dec. 2021. Variables of interest were surgical VE and subventricular (SVZ) contact. Clinical outcomes of interest included perioperative complications, length of stay (LOS), postoperative hydrocephalus, leptomeningeal dissemination and distant parenchymal recurrence, progression-free survival (PFS) and overall survival (OS), and cost of illness was direct medical costs. Analysis was performed using multivariate Logistic, Cox regression, and a multivariate generalized linear model.ResultsOf the 100 patients pathologically diagnosed with glioma invading the thalamus, 64 (64.0%) patients underwent VE during resection. Multivariate analysis after adjusting confounders revealed that surgical VE, but not SVZ contact, was independently associated with the development of perioperative complications (OR 3.52, 95%CI 1.19-10.40; p=0.023), postoperative hydrocephalus (OR 3.70, 95%CI 1.10-12.45; p=0.035), longer LOS (β 5.99, Wald X2 9.12; p=0.003) and increased direct medical costs (β 5349.2, Wald X2 4.56; p=0.033), but was not with the distant parenchymal recurrence, PFS and OS.ConclusionsAlthough surgical VE does not impact survival, it may impose undesirable events and higher financial burdens for patients with gliomas invading the thalamus.Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.

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