Surgical Management of Optic Pathway-Hypothalamic Gliomas: Institutional Experience and Systematic Review.
Julian Brown, Diwas Gautam, Farshad Nassiri et al.
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In 30 seconds
This retrospective institutional series and systematic review examined surgical outcomes for optic pathway-hypothalamic gliomas (OPHGs). The institutional cohort included 9 adults; the review identified 15 studies comprising 50 patients. Visual disturbance was the most common presenting symptom in both groups. Gross total resection was achieved in 33% of the institutional cohort and 12% of literature cases. Tumor recurrence was reported in 3 institutional patients (33%) and 11 literature patients (22%). The authors conclude that surgery may have a role in multidisciplinary care for selected patients, while reporting endocrine, visual, and other complications.
Key findings
- Visual disturbance was the presenting symptom in 56% of institutional patients and 76% of patients in the literature.
- Gross total resection was achieved in 33% of the institutional cohort and 12% of historical cases.
- Recurrence occurred in 3 patients (33%) in the institutional cohort and 11 patients (22%) in the literature.
- Literature-reported complications included new endocrine dysfunction (28%) and visual disturbance (16%).
Why it matters
OPHGs lie near critical structures and have an unpredictable natural history, making the role of resection uncertain. These findings describe both potential surgical outcomes and clinically important complications across an institutional experience and published cases. They support considering surgery as one component of multidisciplinary management in selected patients, rather than implying that resection is appropriate for all OPHGs.
What to keep in mind
The institutional experience was retrospective and included 9 patients; the systematic review drew on 15 studies and 50 patients, with outcomes reported across historical cases.