{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T10:25:16Z","timestamp":1794219916512,"version":"4.8.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Hydrocephalus secondary to CNS tumors is common and carries high shunt failure rates, yet predictors of shunt survival remain poorly defined. The aim of this study was to identify patient-, tumor-, and treatment-related predictors of shunt outcomes in neoplastic hydrocephalus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective single-institution analysis included consecutive patients who underwent ventriculoperitoneal or ventriculoatrial shunt placement for neoplastic hydrocephalus between February 2013 and February 2024. Patients were identified using validated natural language processing and manual review. Demographic, oncological, and surgical variables, including tumor location, neurological symptoms, and resection history, were analyzed. The primary outcome was shunt revision for any cause at 1, 3, and 5 years. Fisher\u2019s exact test or the chi-square test was used for categorical comparisons. Kaplan-Meier and log-rank analyses were used to assess shunt survival, with subgroup analysis for age and etiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Overall, 239 patients (140 female, median age 53 years) were included, with 186 adults and 53 pediatric patients. Intraventricular tumor location showed the strongest association with shunt failure across all time points (5-year OR 4.39, p &lt; 0.001). Preoperative neurological symptoms (seizures and visual\/auditory deficits) were associated with higher odds of single and multiple shunt revisions (OR range 1.92\u20132.15, p \u2264 0.03). WHO grade 2 tumors trended toward greater late (5-year) failure risk (OR 2.8, p = 0.06). Obstruction accounted for 35.6% of shunt failures, followed by infection. Adjuvant chemotherapy and radiation therapy were not associated with shunt failure after adjustment for survival differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In this largest-to-date cohort of patients who underwent shunt placement for neoplastic hydrocephalus, the factors associated with shunt failure were intraventricular tumor location, multiple resections, and preoperative neurological symptoms. Adjuvant therapies had minimal impact. These findings support individualized risk stratification and targeted follow-up and provide a foundation for targeted prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.1.jns252373","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:01:01Z","timestamp":1782259261000},"page":"786-795","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of ventricular shunt survival in neoplastic hydrocephalus: a retrospective cohort study of 239 patients"],"prefix":"10.3171","volume":"145","author":[{"given":"Eric A.","family":"Grin","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C.","family":"Kelleher","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel N.","family":"de Souza","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adhith","family":"Palla","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoran Z.","family":"Gajic","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander N.","family":"Eremiev","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosef M.","family":"Dastagirzada","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey H.","family":"Wisoff","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eveline Teresa","family":"Hidalgo","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Harter","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"J Neurooncol","first-page":"333","article-title":"Ventriculoperitoneal shunt complications in hydrocephalus patients with intracranial tumors: an analysis of relevant risk factors","volume":"103","author":"Reddy GK","year":"2011","unstructured":"Reddy GK, Bollam P, Caldito G, Willis B, Guthikonda B, Nanda A. Ventriculoperitoneal shunt complications in hydrocephalus patients with intracranial tumors: an analysis of relevant risk factors. J Neurooncol. 2011;103(2):333\u2013342. doi:10.1007\/s11060-010-0393-4"},{"issue":"22","key":"b2","series-title":"N Engl J Med","first-page":"2067","article-title":"Infantile and childhood hydrocephalus","volume":"387","author":"Whitehead WE","year":"2022","unstructured":"Whitehead WE, Weiner HL. Infantile and childhood hydrocephalus. N Engl J Med. 2022;387(22):2067\u20132073. doi:10.1056\/NEJMra2116504"},{"issue":"4","key":"b3","series-title":"J Neurosurg Pediatr","first-page":"382","article-title":"Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study","volume":"17","author":"Riva-Cambrin J","year":"2016","unstructured":"Riva-Cambrin J, Kestle JRW, Holubkov R,  Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study. 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