Pediatric Brain Tumor Foundation
Working to eliminate the challenges
of childhood brain tumors
Please leave this field empty

Cure the kids! Give Now

font size AAA

Surgery

Is surgery always performed for children with brain tumors?
What is the difference between a GTR, NTR and STR in surgery?
What are the risks of surgery?
What is the risk of recurrence when the entire tumor has been removed?
Will my child’s tumor tissue be ‘banked’ after surgery?

Is surgery always performed for children with brain tumors?
Not always. Brain tumors can be located in areas that would be dangerous or even impossible to remove (if they involve critical brain structures). When a tumor cannot be safely resected and can be clearly diagnosed by imaging alone, a biopsy may offer no advantage to your child’s treatment, depending on the type of tumor.

Some medical centers are starting to biopsy unresectable tumors more frequently so that they may have a better understanding of their biologic makeup and obtain hints about potential treatments that could be used. In some cases, these types of biopsies may be required to allow your child to participate in a clinical trial in which the safety and effectiveness of a new drug is studied. Tumor tissue is not always required for enrollment on clinical trials, however.

[Return to top]

What’s the difference between a GTR, NTR and STR in surgery?
A gross total resection (GTR) means that there are no visible residual tumor cells under the operating microscope or on the postoperative MRI. A near total resection (NTR) means there is less than 10 percent of residual tumor; subtotal resection (STR) means between 10 to 50 percent remains.

A partial resection means that half or less of the tumor was removed. Keep in mind that even partial resections can have significant effects on relieving pain and other symptoms. For some tumor types, they can be associated with improved survival.

[Return to top]

What are the risks of surgery?
These vary greatly according to the location and size of the tumor. Your neurosurgeon can best advise you on the specific potential risks based on the characteristics of your child’s tumor.

One of the biggest concerns is loss of specific brain functions related to the site being operated on, which is why neurosurgeons are extremely careful about how much tissue to remove. Some children may require speech, occupational and physical therapies after surgery. About one-third of children who have surgery in the posterior fossa -- an area at the back and bottom of the brain --  experience symptoms of posterior fossa syndrome, which includes a temporary loss of the ability to speak, poor co-ordination and difficulty swallowing.

Your child may need a surgically implanted shunt to treat hydrocephalus, a buildup of cerebrospinal fluid (CSF) in the brain, and medication to help prevent seizures. Both of these complications may arise from the tumor or surgery. Post-surgical brain swelling is a risk that can be reduced with corticosteroids, a different type of steroid than those that are abused to build up muscle.  Leakage of CSF is another complication that might indicate infection caused by a tear in the dura, the tissue surrounding the brain and spinal cord.

[Return to top]

What’s the risk of recurrence when the entire tumor has been removed?
This depends on the grade and type of tumor. It’s important to remember that tumors can recur without any symptoms. If a recurrent tumor is identified early, better treatment options may be open to your child.

[Return to top]

Will my child’s tumor tissue be ‘banked’ after surgery?
Before your child’s surgery you will likely be asked to sign a consent form offering permission for the tumor tissue to be used for research and/or stored in a tissue bank. Clinical characteristics of the tissue will be logged into a database, but your child’s identity will be protected. This information will help researchers understand more about brain tumors in order to develop better treatments. This process does not interfere with the pathologist’s work in determining the tumor type and grade. With your consent, the tumor tissue is only used for research after all necessary clinical testing has been done.

[Return to top]