title: Teratomas of the cranial vault: a systematic analysis of clinical outcomes stratified by histopathological subtypes.
abstract: Teratomas of the cranial vault are divided into histopathological subtypes and grouped by prognoses: mature (good prognosis), mixed/malignant and immature teratomas (intermediate prognosis). This schema also includes non-teratomatous tumors. The authors of this study sought to elucidate histologically dependent predictors of survival and further clarify the classification system of intracranial teratomas.
  
  
  
  We performed a systematic analysis of the published literature to identify studies describing patients with intracranial teratomas diagnosed with magnetic resonance imaging (MRI) and presenting definite information on histologies, therapies, and outcomes at a minimum follow-up of 2 years. Disease-free (DFS) and overall survival (OS) were evaluated.
  
  
  
  A total of 18 articles comprised of 134 patients were included. On univariate analysis, male sex and gross-total resection (GTR) were associated with high mean DFS (p = 0.0362 and p < 0.0001, respectively). On multivariate analysis, mature teratomas located in the pineal, and those having undergone subtotal resection (STR) demonstrated high mean OS (p = 0.0023 and p = 0.0044, respectively). Mature and mixed/malignant suprasellar teratomas had equally higher mean OS versus immature suprasellar teratomas (p < 0.0001). Mature and immature teratomas treated with adjuvant therapy had significantly higher mean OS compared to those managed with surgery alone (p = 0.0421 and p = 0.0423, respectively). Males with immature teratomas had the highest mean OS (p < 0.0001). Immature teratomas managed with surgery alone had higher mean DFS, but lower mean OS, compared to those treated with adjuvant therapy (p = 0.0176 and p = 0.0423, respectively).
  
  
  
  Our data highlight the divergent nature of the different histopathological subtypes of teratomas, and suggest that survival outcomes are multifactorial. Specifically, male sex, pineal, suprasellar, GTR, and STR were dependent predictors of OS, while histopathology was an independent predictor of OS.
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA.
authors.forename: Carlito
authors.initials: C
authors.lastname: Lagman
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA.
authors.forename: Timothy T
authors.initials: TT
authors.lastname: Bui
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA.
authors.forename: Brittany L
authors.initials: BL
authors.lastname: Voth
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA.
authors.forename: Lawrance K
authors.initials: LK
authors.lastname: Chung
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Seo
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Duong
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Libowitz
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA.
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Walker
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Nagasawa
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA. iyang@mednet.ucla.edu.|Department of Radiation Oncology, University of California, Los Angeles, 300 Stein Plaza, Los Angeles, 90095-1761, CA, USA. iyang@mednet.ucla.edu.|Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, 90024, CA, USA. iyang@mednet.ucla.edu.
authors.forename: Isaac
authors.initials: I
authors.lastname: Yang
mesh_terms: D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D013724:Teratoma / Q000401:mortality / Q000473:pathology / Q000628:therapy
keywords: Intracranial; Outcomes; Pathology; Teratoma