Intraoperative Ventricular Opening has No Effect on Complication Development Following BCNU Wafer Implantation for Malignant Glioma

OBJECTIVE: To evaluate the safety profile of bis-chloroethyl-nitrosourea (BCNU) wafer implantation after malignant glioma resection with or without ventricular opening (VO).METHODS: This single-center retrospective study included 66 consecutive patients with BCNU wafer im-plantation after malignant glioma resection between March 2013 and August 2021. The patients were catego-rized into 2 groups based on whether VO occurred during the malignant glioma resection. Fifty-eight patients had glioblastoma, and 8 had anaplastic astrocytoma or oligo-dendroglioma. Forty-eight patients underwent an initial treatment, and 18 underwent recurrent surgeries. Infec-tion, hydrocephalus, subcutaneous fluid collection, chronic subdural hematoma, early seizure after surgery within 1 month, symptomatic edema surrounding the resected cavity, cyst formation, and postoperative hemor-rhage were defined as adverse events (AEs).RESULTS: Thirty-three patients underwent resection with VO, and 33 without. The median survival time was 28 months in the initial treatment group and 11.5 months in the recurrent treatment group. The with and without VO groups had similar median survival times. Postoperative AEs occurred in 7/33 patients (21.2%) with VO and 10/33 (30.3%) without VO, with no difference between them (P [ 0.574).CONCLUSIONS: This study showed that VO during sur-gery with BCNU wafer implantation might not influence the occurrence of postoperative AEs. If VO happens, BCNU wafer implantation can be performed safely with accurate closing of the ventricle.

Automated summary

This study evaluated the safety of BCNU wafer implantation after malignant glioma resection, with or without ventricular opening. The results showed similar occurrence of adverse events in both groups, indicating that BCNU wafer implantation is safe and feasible even with ventricular opening.