Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, 310009, People's Republic of China.
J Neurooncol. 2011 Nov;105(2):291-9. doi: 10.1007/s11060-011-0585-6. Epub 2011 May 17.
Despite optimal treatment of post-operative radiotherapy and chemotherapy for newly diagnosed high-grade astrocytoma, nearly all patients eventually recur. However, the efficacy of reoperation for recurrent astrocytoma is still debatable as to different surgical indications. To investigate the therapeutic effect of reoperation on patients with recurrent high-grade astrocytoma more objectively, a retrospective case-matched study was carried out. The clinical data of 63 cases of recurrent high-grade astrocytoma treated between January 2006 and December 2008 were studied. A total of 21 cases received reoperation immediately after tumor recurrence, while 42 cases without reoperation were matched by gender, age, Karnofsky Performance Scale (KPS) score, histopathology, recurrent interval after the first operation, extent of initial surgery, adjuvant treatment and characteristics of recurrent tumor. The study showed that the median survival time was 7 months in the reoperation group, while in non-reoperation group, it was 4 months. There was significant difference on univariate analysis (P < 0.001). Moreover, the median duration time of progression-free survival (PFS) after tumor recurrence was significantly (P < 0.001) longer in the reoperation group (5 months) than that in the non-reoperation group (2.5 months). The prognostic factors of recurrent high-grade astrocytoma included reoperation, KPS score and tumor location. It was indicated that reoperation could prolong the survival time and improve the quality of survival in patients of recurrent high-grade astrocytoma.
尽管对新诊断的高级别星形细胞瘤进行了术后放疗和化疗的最佳治疗，但几乎所有患者最终都会复发。然而，对于复发性星形细胞瘤的再手术疗效，由于不同的手术指征，仍存在争议。为了更客观地研究再手术治疗复发性高级别星形细胞瘤的疗效，进行了一项回顾性病例匹配研究。研究了 2006 年 1 月至 2008 年 12 月期间治疗的 63 例复发性高级别星形细胞瘤患者的临床资料。共有 21 例患者在肿瘤复发后立即接受了再手术，而 42 例未接受再手术的患者按性别、年龄、卡诺夫斯基表现量表（KPS）评分、组织病理学、首次手术后的复发间隔、初始手术范围、辅助治疗和复发性肿瘤的特征进行了匹配。研究表明，再手术组的中位生存时间为 7 个月，而非再手术组为 4 个月。单因素分析显示差异有统计学意义（P < 0.001）。此外，肿瘤复发后无进展生存期（PFS）的中位持续时间在再手术组（5 个月）明显长于非再手术组（2.5 个月）（P < 0.001）。复发性高级别星形细胞瘤的预后因素包括再手术、KPS 评分和肿瘤位置。结果表明，再手术可以延长复发性高级别星形细胞瘤患者的生存时间，提高生存质量。
