Quigley M R, Maroon J C
Department of Neurosurgery, Allegheny General Hospital, Pittsburgh, Pennsylvania.
Neurosurgery. 1991 Sep;29(3):385-8; discussion 388-9. doi: 10.1097/00006123-199109000-00008.
Current neurosurgical opinion favors the radical surgical removal of supratentorial gliomas, when feasible, in the belief that this optimizes patient survival. Although bolstered by the results of some early investigators, the efficacy of this approach remains debatable. Therefore, we undertook a review of the English language literature of the past 30 years for a series of surgically treated malignant gliomas. Twenty reports comprising 5691 patients were identified. Only 4 found the extent of the surgical resection related to survival. In 2 of these, it followed age, histological findings, and performance status in importance. The 2 other studies did not rank the prognostic variables at all. On closer inspection, however, there does appear to be a subgroup of young patients with favorable histological findings and good performance status for whom surgery is beneficial. Future reporting of surgical results of patients with gliomas will require stratification by the known prognostic variables of age, histological findings, and performance status to characterize better this subgroup for whom surgery is beneficial.
目前神经外科的观点倾向于，在可行的情况下，对幕上胶质瘤进行根治性手术切除，因为他们认为这样能使患者的生存率达到最优。尽管一些早期研究者的结果支持了这一观点，但这种方法的疗效仍存在争议。因此，我们对过去30年英文文献中一系列接受手术治疗的恶性胶质瘤进行了综述。共找到20篇报告，涉及5691例患者。只有4篇发现手术切除范围与生存率有关。其中2篇认为，在重要性方面，它仅次于年龄、组织学结果和功能状态。另外2项研究根本没有对预后变量进行排序。然而，仔细研究后发现，似乎有一小部分年轻患者，他们组织学结果良好、功能状态良好，手术对他们是有益的。未来关于胶质瘤患者手术结果的报告，将需要根据年龄、组织学结果和功能状态这些已知的预后变量进行分层，以便更好地界定这一手术受益的亚组。
