{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:32:45Z","timestamp":1792171965299,"version":"4.4.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002839","name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002839","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The extent of resection of pediatric low-grade glioma mostly improves progression-free survival. In chiasmatic hypothalamic glioma (CHG), complete resections are limited due to the relevantly\u00a0high risk of associated neurological and endocrinological deficits. Still, surgery might\u00a0have its role in the framework of a multidisciplinary team (MDT) approach. We report our retrospective experience from two centers on surgical options and their impact on long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records of surgically treated pediatric CHG patients between 2004 and 2022 were analyzed. Patient characteristics, surgical interventions, histology, and non-surgical therapy were retrieved together with outcome measures such as visual acuity, endocrine function, and survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 63 patients (33 female, NF-1,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098) were included. Age at first diagnosis was 4.6 years (range 0.2\u201316.9) and cohort follow-up was 108\u2009\u00b1\u200972 months. Twenty patients were surgically treated with a biopsy and 43 patients with debulking at a median age of 6.5 years (range 0.16\u201316.9). Patients received a median of 2 tumor surgeries (range 1\u20135). Cyst drainage was accomplished in 15 patients, and 27 patients had ventriculoperitoneal shunt implantation. Non-surgical therapy was given in 69.8%. At the end of follow-up, 74.6% of patients had stable disease. The cohort had a median Karnofsky score of 90 (range 0\u2013100). Four patients died. Hormone substitution was necessary in 30.2%, and visual acuity was impaired in 66% of patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric CHG is a chronic disease due to overall high survival with multiple progressions. Surgical therapy remains a key treatment option offering biopsy, limited tumor-debulking, cyst fenestration, and hydrocephalus management in the framework of MDT decision-making. Team experience contributes to reducing possible deficits in this challenging cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-024-06498-2","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T12:02:13Z","timestamp":1719316933000},"page":"3065-3074","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Surgical options of chiasmatic hypothalamic glioma\u2014a relevant part of therapy in an interdisciplinary approach for tumor control"],"prefix":"10.1007","volume":"40","author":[{"given":"Anna-Gila","family":"Karbe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gorodezki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Tietze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Gruen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Hern\u00e1iz","family":"Driever","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin U.","family":"Schuhmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich-Wilhelm","family":"Thomale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,25]]},"reference":[{"issue":"970","key":"6498_CR1","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1259\/bjr\/65246351","volume":"81","author":"T Taylor","year":"2008","unstructured":"Taylor T, Jaspan T, Milano G, Gregson R, Parker T, Ritzmann T et al (2008) Radiological classification of optic pathway gliomas: experience of a modified functional classification system. Br J Radiol 81(970):761\u2013766. https:\/\/doi.org\/10.1259\/bjr\/65246351","journal-title":"Br J Radiol"},{"issue":"10","key":"6498_CR2","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1093\/neuonc\/nos202","volume":"14","author":"AK Gnekow","year":"2012","unstructured":"Gnekow AK, Falkenstein F, von Hornstein S, Zwiener I, Berkefeld S, Bison B et al (2012) Long-term follow-up of the multicenter, multidisciplinary treatment study HIT-LGG-1996 for low-grade glioma in children and adolescents of the German Speaking Society of Pediatric Oncology and Hematology. Neuro Oncol 14(10):1265\u20131284. https:\/\/doi.org\/10.1093\/neuonc\/nos202","journal-title":"Neuro Oncol"},{"issue":"6","key":"6498_CR3","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1055\/s-2004-832358","volume":"216","author":"M Warmuth-Metz","year":"2004","unstructured":"Warmuth-Metz M, Gnekow AK, Muller H, Solymosi L (2004) Differential diagnosis of suprasellar tumors in children. Klin Padiatr 216(6):323\u2013330. https:\/\/doi.org\/10.1055\/s-2004-832358","journal-title":"Klin Padiatr"},{"issue":"1","key":"6498_CR4","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.media.2011.07.001","volume":"16","author":"L Weizman","year":"2012","unstructured":"Weizman L, Ben Sira L, Joskowicz L, Constantini S, Precel R, Shofty B, Ben Bashat D (2012) Automatic segmentation, internal classification, and follow-up of optic pathway gliomas in MRI. Med Image Anal 16(1):177\u2013188. https:\/\/doi.org\/10.1016\/j.media.2011.07.001","journal-title":"Med Image Anal"},{"issue":"4","key":"6498_CR5","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1093\/neuonc\/nos330","volume":"15","author":"DA Walker","year":"2013","unstructured":"Walker DA, Liu J, Kieran M, Jabado N, Picton S, Packer R et al (2013) A multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method. Neuro Oncol 15(4):462\u2013468. https:\/\/doi.org\/10.1093\/neuonc\/nos330","journal-title":"Neuro Oncol"},{"issue":"3","key":"6498_CR6","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1055\/a-0889-8256","volume":"231","author":"AK Gnekow","year":"2019","unstructured":"Gnekow AK, Kandels D, Tilburg CV, Azizi AA, Opocher E, Stokland T et al (2019) SIOP-E-BTG and GPOH guidelines for diagnosis and treatment of children and adolescents with low grade glioma. Klin Padiatr 231(3):107\u2013135. https:\/\/doi.org\/10.1055\/a-0889-8256","journal-title":"Klin Padiatr"},{"issue":"12","key":"6498_CR7","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1056\/NEJMoa2303815","volume":"389","author":"E Bouffet","year":"2023","unstructured":"Bouffet E, Hansford JR, Garre ML, Hara J, Plant-Fox A, Aerts I et al (2023) Dabrafenib plus trametinib in pediatric glioma with BRAF V600 mutations. N Engl J Med 389(12):1108\u20131120. https:\/\/doi.org\/10.1056\/NEJMoa2303815","journal-title":"N Engl J Med"},{"issue":"24","key":"6498_CR8","doi-asserted-by":"publisher","first-page":"7303","DOI":"10.1158\/1078-0432.CCR-19-2177","volume":"25","author":"DR Hargrave","year":"2019","unstructured":"Hargrave DR, Bouffet E, Tabori U, Broniscer A, Cohen KJ, Hansford JR et al (2019) Efficacy and safety of dabrafenib in pediatric patients with BRAF V600 mutation-positive relapsed or refractory low-grade glioma: results from a phase I\/IIa study. Clin Cancer Res 25(24):7303\u20137311. https:\/\/doi.org\/10.1158\/1078-0432.CCR-19-2177","journal-title":"Clin Cancer Res"},{"issue":"2","key":"6498_CR9","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1093\/neuonc\/nox141","volume":"20","author":"DTW Jones","year":"2018","unstructured":"Jones DTW, Kieran MW, Bouffet E, Alexandrescu S, Bandopadhayay P, Bornhorst M et al (2018) Pediatric low-grade gliomas: next biologically driven steps. Neuro Oncol 20(2):160\u2013173. https:\/\/doi.org\/10.1093\/neuonc\/nox141","journal-title":"Neuro Oncol"},{"issue":"6","key":"6498_CR10","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1055\/s-2004-832355","volume":"216","author":"AK Gnekow","year":"2004","unstructured":"Gnekow AK, Kortmann RD, Pietsch T, Emser A (2004) Low grade chiasmatic-hypothalamic glioma-carboplatin and vincristin chemotherapy effectively defers radiotherapy within a comprehensive treatment strategy -- report from the multicenter treatment study for children and adolescents with a low grade glioma -- HIT-LGG 1996 -- of the Society of Pediatric Oncology and Hematology (GPOH). Klin Padiatr 216(6):331\u2013342. https:\/\/doi.org\/10.1055\/s-2004-832355","journal-title":"Klin Padiatr"},{"issue":"1","key":"6498_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2013.8.PEDS12546","volume":"13","author":"J Goodden","year":"2014","unstructured":"Goodden J, Pizer B, Pettorini B, Williams D, Blair J, Didi M et al (2014) The role of surgery in optic pathway\/hypothalamic gliomas in children. J Neurosurg Pediatr 13(1):1\u201312. https:\/\/doi.org\/10.3171\/2013.8.PEDS12546","journal-title":"J Neurosurg Pediatr"},{"issue":"7","key":"6498_CR12","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1007\/s00381-022-05515-6","volume":"38","author":"P Spennato","year":"2022","unstructured":"Spennato P, De Rosa A, Meccariello G, Quaglietta L, Imperato A, Scala MR et al (2022) Endoscopic ultrasonic aspiration as alternative to more invasive surgery in initial management of optic pathway gliomas in children. Childs Nerv Syst 38(7):1281\u20131287. https:\/\/doi.org\/10.1007\/s00381-022-05515-6","journal-title":"Childs Nerv Syst"},{"issue":"6","key":"6498_CR13","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1007\/s00381-009-1055-8","volume":"26","author":"UW Thomale","year":"2010","unstructured":"Thomale UW, Hosch H, Koch A, Schulz M, Stoltenburg G, Haberl EJ, Sprung C (2010) Perforation holes in ventricular catheters\u2013is less more? Childs Nerv Syst 26(6):781\u2013789. https:\/\/doi.org\/10.1007\/s00381-009-1055-8","journal-title":"Childs Nerv Syst"},{"issue":"11","key":"6498_CR14","doi-asserted-by":"publisher","first-page":"3313","DOI":"10.1007\/s00381-021-05243-3","volume":"37","author":"UW Thomale","year":"2021","unstructured":"Thomale UW (2021) Integrated understanding of hydrocephalus - a practical approach for a complex disease. Childs Nerv Syst 37(11):3313\u20133324. https:\/\/doi.org\/10.1007\/s00381-021-05243-3","journal-title":"Childs Nerv Syst"},{"issue":"9","key":"6498_CR15","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1007\/s00381-015-2787-2","volume":"31","author":"M Schulz","year":"2015","unstructured":"Schulz M, Spors B, Thomale UW (2015) Stented endoscopic third ventriculostomy-indications and results. Childs Nerv Syst 31(9):1499\u20131507. https:\/\/doi.org\/10.1007\/s00381-015-2787-2","journal-title":"Childs Nerv Syst"},{"issue":"3","key":"6498_CR16","doi-asserted-by":"publisher","first-page":"316","DOI":"10.3171\/2022.6.PEDS22108","volume":"30","author":"UW Thomale","year":"2022","unstructured":"Thomale UW, Gnekow AK, Kandels D, Bison B, Hernaiz Driever P, Witt O et al (2022) Long-term follow-up of surgical intervention pattern in pediatric low-grade gliomas: report from the German SIOP-LGG 2004 cohort. J Neurosurg Pediatr 30(3):316\u2013329. https:\/\/doi.org\/10.3171\/2022.6.PEDS22108","journal-title":"J Neurosurg Pediatr"},{"key":"6498_CR17","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-024-06450-4","author":"JW Kim","year":"2024","unstructured":"Kim JW, Kim SK (2024) The role of surgery for optic pathway gliomas in the era of precision medicine. Childs Nerv Syst. https:\/\/doi.org\/10.1007\/s00381-024-06450-4","journal-title":"Childs Nerv Syst"},{"issue":"8","key":"6498_CR18","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1002\/ijc.34615","volume":"153","author":"S Weiss","year":"2023","unstructured":"Weiss S, Thomale UW, Schulz M, Kandels D, Schuhmann MU, El Damaty A et al (2023) Neurosurgical morbidity in pediatric supratentorial midline low-grade glioma: results from the German LGG studies. Int J Cancer 153(8):1487\u20131500. https:\/\/doi.org\/10.1002\/ijc.34615","journal-title":"Int J Cancer"},{"issue":"12","key":"6498_CR19","doi-asserted-by":"publisher","first-page":"3471","DOI":"10.1002\/ijc.33170","volume":"147","author":"D Kandels","year":"2020","unstructured":"Kandels D, Pietsch T, Bison B, Warmuth-Metz M, Thomale UW, Kortmann RD et al (2020) Loss of efficacy of subsequent nonsurgical therapy after primary treatment failure in pediatric low-grade glioma patients-report from the German SIOP-LGG 2004 cohort. Int J Cancer 147(12):3471\u20133489. https:\/\/doi.org\/10.1002\/ijc.33170","journal-title":"Int J Cancer"},{"issue":"1","key":"6498_CR20","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1038\/s41591-023-02668-y","volume":"30","author":"LB Kilburn","year":"2024","unstructured":"Kilburn LB, Khuong-Quang DA, Hansford JR, Landi D, van der Lugt J, Leary SES et al (2024) The type II RAF inhibitor tovorafenib in relapsed\/refractory pediatric low-grade glioma: the phase 2 FIREFLY-1 trial. Nat Med 30(1):207\u2013217. https:\/\/doi.org\/10.1038\/s41591-023-02668-y","journal-title":"Nat Med"},{"issue":"1","key":"6498_CR21","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1186\/s12885-024-11820-x","volume":"24","author":"CM van Tilburg","year":"2024","unstructured":"van Tilburg CM, Kilburn LB, Perreault S, Schmidt R, Azizi AA, Cruz-Martinez O et al (2024) LOGGIC\/FIREFLY-2: a phase 3, randomized trial of tovorafenib vs. chemotherapy in pediatric and young adult patients with newly diagnosed low-grade glioma harboring an activating RAF alteration. BMC Cancer 24(1):147","journal-title":"BMC Cancer"},{"key":"6498_CR22","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-024-06407-7","author":"I Albalkhi","year":"2024","unstructured":"Albalkhi I, Shafqat A, Bin-Alamer O, Mallela AN, Gersey ZC, Fernandes Cabral D et al (2024) Complications and visual outcomes following surgical resection of pediatric optic pathway\/hypothalamic gliomas: a systematic review and meta-analysis. Childs Nerv Syst. https:\/\/doi.org\/10.1007\/s00381-024-06407-7","journal-title":"Childs Nerv Syst"},{"key":"6498_CR23","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00766","volume":"11","author":"C Liao","year":"2020","unstructured":"Liao C, Zhang H, Liu Z, Han Z, Li C, Gong J et al (2020) The visual acuity outcome and relevant factors affecting visual improvement in pediatric sporadic chiasmatic-hypothalamic glioma patients who received surgery. Front Neurol 11:766. https:\/\/doi.org\/10.3389\/fneur.2020.00766","journal-title":"Front Neurol"},{"key":"6498_CR24","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noae045","author":"A Morin","year":"2024","unstructured":"Morin A, Allodji R, Kariyawasam D, Touraine P, Puget S, Beccaria K et al (2024) Very long-term outcomes of pediatric patients treated for optic pathway gliomas: a longitudinal cohort study. Neuro Oncol. https:\/\/doi.org\/10.1093\/neuonc\/noae045","journal-title":"Neuro Oncol"}],"container-title":["Child's Nervous System"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-024-06498-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00381-024-06498-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-024-06498-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T03:12:28Z","timestamp":1729825948000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00381-024-06498-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,25]]},"references-count":24,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["6498"],"URL":"https:\/\/doi.org\/10.1007\/s00381-024-06498-2","relation":{},"ISSN":["0256-7040","1433-0350"],"issn-type":[{"value":"0256-7040","type":"print"},{"value":"1433-0350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,25]]},"assertion":[{"value":"30 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"UWT received lecture honorarium by Miethke\/ Aesculap\/ B Braun company.\u00a0No conflict of interest is declared by any of\u00a0the other\u00a0authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}