{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:43:21Z","timestamp":1786977801645,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2023,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Surgical resection is a mainstay of treatment for pediatric low\u2010grade glioma (LGG) within all current therapy algorithms, yet associated morbidity is scarcely reported. As supratentorial midline (SML) interventions are particularly challenging, we investigated the frequency of neurosurgical complications\/new impairments aiming to identify their risk factors. Records were retrospectively analyzed from 318 patients with SML\u2010LGG from successive German multicenter LGG studies, undergoing surgery between May 1998 and June 2020. Exactly 537 operations (230 resections, 167 biopsies, 140 nontumor procedures) were performed in 318 patients (54% male, median age: 7.6\u2009years at diagnosis, 9.5\u2009years at operation, 11% NF1, 42.5% optic pathway glioma). Surgical mortality rate was 0.93%. Applying the Drake classification, postoperative surgical morbidity was observed following 254\/537 (47.3%) and medical morbidity following 97\/537 (18.1%) patients with a 40.1% 30\u2010day persistence rate for newly developed neurological deficits (65\/162). Neuroendocrine impairment affected 53\/318 patients (16.7%), visual deterioration 34\/318 (10.7%). Postsurgical morbidity was associated with patient age &lt;3\u2009years at operation, tumor volume \u226580\u2009cm\n                    <jats:sup>3<\/jats:sup>\n                    , presence of hydrocephalus, complete resection, surgery in centers with less than median reported tumor\u2010related procedures and during the earlier study period between 1998 and 2006, while the neurosurgical approach, tumor location, NF1 status or previous nonsurgical treatment were not. Neurosurgery\u2010associated morbidity was frequent in pediatric patients with SML\u2010LGG undergoing surgery in the German LGG\u2010studies. We identified patient\u2010 and institution\u2010associated factors that may increase the risk for complications. We advocate that local multidisciplinary teams consider the planned extent of resection and surgical skills.\n                  <\/jats:p>","DOI":"10.1002\/ijc.34615","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T09:04:52Z","timestamp":1685610292000},"page":"1487-1500","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Neurosurgical morbidity in pediatric supratentorial midline low\u2010grade glioma: Results from the German\n                    <scp>LGG<\/scp>\n                    studies"],"prefix":"10.1002","volume":"153","author":[{"given":"Sarah","family":"Wei\u00df","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology and Hematology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4985-9847","authenticated-orcid":false,"given":"Ulrich\u2010Wilhelm","family":"Thomale","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5151-6443","authenticated-orcid":false,"given":"Matthias","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8631-868X","authenticated-orcid":false,"given":"Daniela","family":"Kandels","sequence":"additional","affiliation":[{"name":"Swabian Children's Cancer Center, Faculty of Medicine University Augsburg  Augsburg 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