Location-Molecular Integrated Outcomes in 450 Cerebellar Glioma Microsurgical Cases

The goal of this observational study is to learn if refined anatomical location-combined with molecular biomarkers-can predict surgical success and long-term survival in 450 adults and children with cerebellar gliomas who underwent microsurgical resection at a single center between 2014 and 2024. The main questions it aims to answer are: 1. Does tumor location (cerebellar hemisphere, vermis, fourth ventricle, or pontocerebellar-angle region) independently influence extent of resection and overall survival after adjustment for WHO grade and molecular profile? 2. Among IDH-wild-type low-grade gliomas, does gross-total resection plus early adjuvant radiotherapy improve 5-year overall and progression-free survival compared with lesser resection or radiotherapy omission? Researchers compared four anatomical subgroups and multiple molecular subtypes (IDH, 1p/19q, MGMT, TERT, BRAF V600E) to quantify location-specific resection rates, complication rates, and survival outcomes. Participants underwent standardized pre-operative imaging, microsurgical resection with intra-operative monitoring when indicated, post-operative MRI within 48 h to quantify residual tumor, and longitudinal clinical and radiographic follow-up every 3-12 months for up to 10 years.

Sex

All

Minimum age

3 Years

Maximum age

80 Years

Inclusion Criteria

* Pathologically proven cerebellar glioma (hemisphere, vermis, fourth ventricle, or pontocerebellar-angle region) per 2021 WHO CNS classification
* First microsurgical resection performed at our center between January 2014 and January 2024
* Age ≥ 3 years at surgery
* Pre-operative Karnofsky Performance Status (KPS) recorded
* Availability of post-operative contrast MRI for resection-extent calculation
* Minimum required molecular data: IDH1/2 status (immunohistochemistry ± sequencing)
* Continuous follow-up ≥ 6 months after surgery (out-patient visits or telephone confirmation)

Exclusion Criteria

* Brain-stem glioma with secondary cerebellar invasion
* Recurrent or metastatic glioma
* Previous cranial radiation or glioma surgery at another institution
* Palliative resection (\< 20 % of tumor volume removed)
* Missing post-operative MRI or insufficient tissue for mandatory IDH testing
* Follow-up \< 6 months or lost to follow-up before 6-month landmark