SURG-16. MULTIDISCIPLINARY TREATMENT OF HEMANGIOBLASTOMAS IN CENTRAL NERVOUS SYSTEM AND FUTURE PROSPECTS

Abstract Hemangioblastomas (HB) in central nervous system are originally benign tumors. However, they are extremely vascular and appropriate treatment of the feeders and drainers is important when performing HB resection. Approximately 20% of HB cases are thought to be caused by von Hippel-Lindau (VHL) disease. Patients with VHL disease often develop multiple HBs, and it may be difficult to treat them with excision alone. Recently, belzutifan, a molecular targeted drug indicated for treating HB in VHL disease cases, was approved by FDA. In this presentation, we will provide an overview of the multidisciplinary treatment at our facility. METHOD At our facility, we performed 84 cases of excision surgery from 1996 to 2019, and analyzed the results of these treatments. A high-definition 3D fused image was created before surgery to identify the feeders and drainers. Tumor embolization was performed on the feeder, which was thought to be located deep within the surgical field. In addition, gamma knife treatment was performed as appropriate for HBs that did not undergo extirpation. RESULTS The breakdown of cases was 46 with VHL disease and 38 with non-VHL disease. Postoperatively, KPS improved in 55% of cases, and some complications occurred in 18%. Gamma Knife treatment has been performed on 58 cases so far, and the 10-year tumor control rate is approximately 80%. DISCUSSION/SUMMARY This presentation revealed that multidisciplinary treatment is effective for HBs. In the future it is necessary to consider which HB cases belzutifan is useful for and how it should be combined with other treatments.