Surgically treated brain tumors: a retrospective case series of 10,009 cases at a single institution.

OBJECTIVE

To evaluate the chronologic trends in brain tumor surgery at a single institution over 53 years (1957-2009).

METHODS

Data were collected from medical records and documents (eg, daily records, surgical notes, or electronic databases) preserved in the library of the Department of Neurosurgery, Seoul National University College of Medicine.

RESULTS

During the period 1957-2009, 10,009 brain tumors were surgically treated. Glial tumor (25.2%) was the most frequently reported histologic category. Meningioma and pituitary adenoma accounted for 17.5% and 17.1% of the histologies. In children <20 years old, astrocytoma (16.7%), embryonal tumor (16.2%), and germ cell tumor (11.9%) were the most common histologies. The chronologic trend for changes in proportions of individual brain tumor surgeries showed that cases of glioma have gradually increased since the 1980s, whereas cases of benign extra-axial tumors, including meningioma, sellar tumor, and schwannoma, have decreased. This trend implies that the presurgical diagnosis of glioma has increased owing to modern imaging technologies, and alternative treatment options, such as radiosurgery or observation, have been more frequently applied over time to benign extra-axial tumors. Simultaneously, the surgical management of lymphoma and metastatic tumor has increased gradually.

CONCLUSIONS

This article describes the largest series of chronologic analysis of brain tumor surgeries conducted at a single institution and reflects the longitudinal trends by treatment option in incidences of selected brain tumors.