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World neurosurgery 成人颅咽管瘤长期随访的复发率和预后因素。
影响因子:2.21 DOI:10.1016/j.wneu.2019.08.209
作者: Park HJ,Dho YS,Kim JH,Kim JW,Park CK,Kim YH 发表时间:2020-07-10 14:30:39
keywords: Park HJDho YSKim JHKim JWPark CKKim YH
关键词: 颅咽管瘤 长期 复发 危险因素
Abstract
BACKGROUND:Craniopharyngiomas show a high recurrence rate despite their pathologically benign nature. Thus, we analyzed the clinical features to elucidate the prognostic factors for the recurrence of craniopharyngiomas in adults with long-term follow-up. METHODS:This retrospective study reviewed and analyzed the preoperative features, surgical results, and tumor recurrence of patients who underwent an operation at a single institution from 2004 to 2013. RESULTS:This study analyzed the results of 64 consecutive adult patients, and the median follow-up period was 83.5 months (range 9-163 months). Ten patients had a history of surgery, whereas 4 had a history of adjuvant radiation. Retrochiasmatic tumors (n = 51, 79.7%) were more common than prechiasmatic tumors. Operations were performed via the transcranial approach in 31 (48.4%) patients and transsphenoidal approach in 33. Gross total removal was achieved in 44 (68.8%) patients, and the transsphenoidal approach showed a greater gross total removal rate than the transcranial approach did (97.0% vs. 38.7%, P < 0.001). Adjuvant radiotherapy was performed in 8 patients, and radiosurgery was performed in 2. Recurrence was identified in 25 (39.1%) patients in 45.0 months of the median time to recurrence. The overall actuarial 5- and 7-year progression-free survival rates were 71.8% and 63.6%, respectively. Multivariate analysis revealed that supra- and subdiaphragmatic tumor locations and subtotal removal were risk factors for long-term tumor recurrence. CONCLUSIONS:The long-term recurrence rate of craniopharyngiomas was high; therefore, long-term regular follow-up is mandatory. Adjuvant irradiation for remnant tumors showed a long-term tumor control rate comparable to that of completely removed tumors.
摘 要
背景: 尽管颅咽管瘤的病理性质是良性的,但其复发率很高。因此,我们分析了长期随访的成人颅咽管瘤复发的临床特征,以阐明预后因素。 方法: 本回顾性研究回顾并分析了 2004 年至 2013 年在单个机构接受手术的患者的术前特征、手术结果和肿瘤复发情况。 结果: 本研究分析了 64 例连续成人患者的结果,中位随访期为 83.5 个月 (范围 9-163 个月)。10 例患者有手术史,4 例有辅助放疗史。视交叉后肿瘤 (n = 51,79.7%) 比视交叉前肿瘤更常见。经颅入路手术 31 例 (48.4%),经蝶入路手术 33 例。44 例 (68.8%) 患者实现了大体全切除,经蝶入路的大体全切除率高于经颅入路 (97.0% vs. 38.7%,P <0.001)。辅助放疗 8 例,放射外科治疗 2 例。25 例 (39.1%) 患者在中位复发时间的 45.0 个月内发现复发。总体精算 5 年和 7 年无进展生存率分别为 71.8% 和 63.6%。多因素分析发现膈上、膈下肿瘤位置和次全切除是肿瘤长期复发的危险因素。 结论: 颅咽管瘤的长期复发率高; 因此,长期定期随访是强制性的。残余肿瘤的辅助照射表现出与完全切除肿瘤相当的长期肿瘤控制率。
期刊介绍
《World Neurosurgery》 (点击进入期刊详情)
英文简介 : World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal's mission is to: To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
中文简介 : (来自Google、百度翻译) 《世界神经外科》拥有开放获取的镜像期刊《世界神经外科:X》,目标和范围相同,编辑团队、投稿系统和严格的同行评审。 《华尔街日报》的使命是: 为神经外科医生和护理神经外科患者的提供者提供一流的国际论坛和双向对话渠道。交换信息的类别包括临床和基础科学,以及提供社会、政治、教育、经济、文化或社会见解和知识的全球信息,这些见解和知识对全球神经外科患者的护理具有重要意义和相关性。 作为激发创造力、创造新知识和提高全球神经外科护理质量的主要智力催化剂。 提供一个交流的论坛,丰富所有神经外科医生及其同事的生活;通过这样做,他们的病人的生活变得丰富多彩。 世界神经外科的主题包括:教育、经济学、研究、政治、历史、文化、临床科学、实验室科学、技术、手术技术、临床图像、视频
CIRCULATION RESEARCH 期刊中科院评价数据
新中科院分区
大类(学科) 小类(学科) 学科排名
医学

CLINICAL NEUROLOGY (临床神经病学)

SURGERY (外科)

139/197
95/200
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1637 1418 219

总被引频次 :10159

特征因子 : 0.023420

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