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Claudia M. C. Faria, James T. Rutka, Christian Smith, and Paul Kongkham

modifications, and RNA-based mechanisms, which function to regulate normal cellular processes such as genomic imprinting, X chromosome inactivation, patterning by Hox genes, and developmental and tissue-specific gene expression. 69 Epigenetic “tags” on genomic DNA are established early during development and differentiation. The dysregulation of these mechanisms may cause altered gene expression, contributing to the origin of human diseases including cancer. 30 Pediatric brain tumors are the most common solid neoplasms in children and represent the leading cause of

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Aliasgar V. Moiyadi and Prakash Shetty

S urgery is an important constituent of the overall treatment of pediatric brain tumors. Extent of resection is a crucial predictor of outcomes, especially in certain tumors like medulloblastomas, 12 and this is reflected in the fact that repeat surgery for residual tumor, as well as the concept of second-look surgery, has gained popularity in recent years. 4 , 12 Generally, neurosurgeons are circumspect about repeat surgeries. Loss of anatomical landmarks, violated surgical planes, and adhesions pose significant challenges to safe dissection and often

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Aria Fallah, Alexander G. Weil, Samir Sur, Ian Miller, Prasanna Jayakar, Glenn Morrison, Sanjiv Bhatia, and John Ragheb

, observational cohort study to describe the efficacy of epilepsy surgery in pediatric patients with brain tumors. The population of interest consisted of consecutive children with medically intractable epilepsy (defined as ongoing seizures after treatment with at least 2 antiepileptic drugs [AEDs] and beginning a third AED at the time of epilepsy surgery referral and workup) related to a pediatric brain tumor who underwent a resection primarily for epilepsy and, in certain cases, for an oncological indication at Miami Children’s Hospital from June 1986 to June 2014

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Samuel Cheshier, Michael D. Taylor, Olivier Ayrault, and Sabine Mueller

P ediatric patients with primary brain tumors present some of the most challenging cases encountered by neurosurgeons. Brain tumors are the second most common neoplasms in children and the most common solid neoplasms. Furthermore, brain tumors have overtaken leukemia as the leading cause of childhood cancer death. 1 Surgical and adjuvant therapies result in reasonably good survival rates in many pediatric brain tumor types. For instance, standard treatment (maximal safe resection, craniospinal irradiation, and myeloablative chemotherapy) results in long

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Albert H. Kim, Elizabeth A. Thompson, Lance S. Governale, Catalina Santa, Kevin Cahll, Mark W. Kieran, Susan N. Chi, Nicole J. Ullrich, R. Michael Scott, and Liliana C. Goumnerova

exhibit recurrence on follow-up MRI? 2) Was radiographic recurrence associated with new neurological symptoms or a clinical intervention? The estimated financial cost of postoperative surveillance in terms of modern US dollars was also assessed. Based on these data, we propose a modified, less frequent schedule of postoperative MRI surveillance to follow these patients. Methods Patients and Follow-Up The Pediatric Brain Tumor Program database (Dana-Farber Cancer Institute) spanning 1993–2003 was retrospectively examined to identify patients who were diagnosed

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Alexandra Cutillo, Kathrin Zimmerman, Susan Davies, Avi Madan-Swain, Wendy Landier, Anastasia Arynchyna, and Brandon G. Rocque

potentially increase the quality of care these patients receive. The purpose of the present investigation was to evaluate communication between parent and neurosurgical team soon after resection of a pediatric brain tumor. Methods Participants Study participant recruitment took place at a tertiary care hospital in the southeastern United States that diagnoses and treats 25 to 40 new pediatric patients with a brain tumor per year. Study participants were recruited as part of a larger study investigating psychosocial impact and distress after diagnosis of a pediatric brain

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Markus Bookland, Eileen Gillan, Xianyuan Song, and Antonina Kolmakova

, conclusions about whether changes in serum miRNA represent changes in the tumor biology or changes in the host biology cannot be drawn with any certainty. Without this understanding, neurosurgeons and neurooncologists cannot be certain that aberrations in serum miRNA expression levels truly represent the presence of oncological tissues, and they cannot discern whether miRNA changes during therapy are the result of treatment impact on the tumor or the patient. In short, understanding the derivation of serum miRNA changes in pediatric brain tumor patients does not preclude

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Todd C. Hankinson, Roy W. R. Dudley, Michelle R. Torok, Mohana Rao Patibandla, Kathleen Dorris, Seerat Poonia, C. Corbett Wilkinson, Jennifer L. Bruny, Michael H. Handler, and Arthur K. Liu

provides both ease of data collection and the intuitive sense of a direct relationship between the intervention and the outcome. In the absence of benchmark data, however, the value of a given measurement may be difficult to assess. In addition, accurate understanding of the mortality risk that is faced by children with complex disease contributes substantially to the optimization of surgical and multidisciplinary management plans. European population-based studies recently reported all-cause 30-day mortality rates following craniotomy for pediatric brain tumors to be

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Mitchell T. Foster, Dawn Hennigan, Rebecca Grayston, Kirsten van Baarsen, Geraint Sunderland, Christopher Paul Millward, Harishchandra Lalgudi Srinivasan, Deborah Ferguson, Teddy Totimeh, Barry Pizer, and Conor Mallucci

brain tumor surgery or even resection rates according to a predefined surgical goal, as there are no current requirements to do so. Pediatric brain tumor surgery is inherently high risk for several reasons, including a high incidence of large tumors, complex midline tumors, and posterior fossa tumors in comparison to adult neurooncology surgery. Routine, transparent, and reproducible outcome reporting is thus important in developing realistic expectations and benchmarks against which units may compare their service. Reporting outcomes such as 30-day mortality and

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Zulma Tovar-Spinoza and Hoon Choi

tumor destruction 41 and provides advantages such as decreased discomfort, reduced overall morbidity, and fewer complications compared with conventional surgical techniques. 20 We previously described the MRgLITT technology and its use in children. 6 , 25 , 34 Here, we report the preliminary results of the first series of heterogeneous pediatric brain tumors treated with MRgLITT at Golisano Children's Hospital in Syracuse, New York. Methods Study Design Approval from the SUNY Upstate Medical University Institutional Review Board was obtained to