Stmo-15 the clinical impact of ventricular opening in the implantation of bcnu wafers for malignant glioma

Abstract 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 61 consecutive patients with BCNU wafer implantation after malignant glioma resection between March 2013 and April 2021. The patients were categorized into two groups based on whether VO occurred during the malignant glioma resection. Fifty-three patients had glioblastoma, and eight had anaplastic astrocytoma or oligodendroglioma. Forty-five patients underwent an initial treatment, and 16 underwent recurrent surgeries. Symptomatic edema, newly occurring seizures within one month of the surgery, wound infection, brain abscess, hydrocephalus, cerebrospinal fluid leak, postoperative hemorrhage, and cyst formation were defined as adverse events (AEs). Results Twenty-nine patients underwent resection with VO, and 32 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 7/29 patients (24.1%) with VO and 11/32 (34.4%) without VO, with no difference between them (p = 0.414). Conclusions This study showed that VO during surgery 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.