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19.12.2023 | Review

Clinical course of ventriculoperitoneal shunting for hydrocephalus following glioblastoma surgery: a systematic review and meta-analysis

verfasst von: Victor M. Lu, Adham M. Khalafallah, Emade Jaman, Muhammet Enes Gurses, Ricardo J. Komotar, Michael E. Ivan, Ashish H. Shah

Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2023

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Abstract

Background

Surgical resection of glioblastoma (GBM) remains a cornerstone in the current treatment paradigm. The postoperative evolution of hydrocephalus necessitating ventriculoperitoneal shunting (VPS) continues to be defined. Correspondingly the objective of this study was to aggregate pertinent metadata to better define the clinical course of VPS for hydrocephalus following glioblastoma surgery in light of contemporary management.

Methods

Searches of multiple electronic databases from inception to November 2023 were conducted following PRISMA guidelines. Articles were screened against pre-specified criteria. Outcomes were pooled by random-effects meta-analyses where possible.

Results

A total of 12 cohort studies satisfied all selection criteria, describing a total of 6,098 glioblastoma patients after surgery with a total of 261 (4%) of patients requiring postoperative VPS for hydrocephalus. Meta-analysis demonstrated the estimated pooled rate of symptomatic improvement following VPS was 78% (95% CI 66–88), and the estimated pooled rate of VPS revision was 24% (95% CI 16–33). Pooled time from index glioblastoma surgery to VPS surgery was 4.1 months (95% CI 2.8–5.3), and pooled survival time for index VPS surgery was 7.3 months (95% CI 5.4–9.4). Certainty of these outcomes were limited by the heterogenous and palliative nature of postoperative glioblastoma management.

Conclusions

Of the limited proportion of glioblastoma patients requiring VPS surgery for hydrocephalus after index surgery, 78% patients are expected to show symptom improvement, and 24% can expect to undergo revision surgery. An individualized approach to each patient is required to optimize both index glioblastoma and VPS surgeries to account for anatomy and goals of care given the poor prognosis of this tumor overall.

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Titel: Clinical course of ventriculoperitoneal shunting for hydrocephalus following glioblastoma surgery: a systematic review and meta-analysis
verfasst von: Victor M. Lu
Adham M. Khalafallah
Emade Jaman
Muhammet Enes Gurses
Ricardo J. Komotar
Michael E. Ivan
Ashish H. Shah
Publikationsdatum: 19.12.2023
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 3/2023
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-023-04538-6

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