Steiger H J, Markwalder R V, Seiler R W, Ebeling U, Reulen H J
Department of Neurosurgery, University Hospital, Berne, Switzerland.
Acta Neurochir (Wien). 1990;106(3-4):99-105. doi: 10.1007/BF01809449.
50 adult supratentorial low-grade astrocytomas operated upon between 1984 and 1988 were analysed retrospectively with respect to postoperative condition and progression-free survival. Pilocytic lesions were excluded. In 32 instances the tumour was macroscopically completely removed and partially in 4. In 14 cases a stereotactic biopsy was performed only. 10 patients received postoperative radiotherapy with 55 to 65 Gy. 1 patient died perioperatively from pulmonary embolism. 39 patients could resume their previous activities after discharge from the hospital, 10 were significantly disabled by neurological deficit, reduced neuropsychological performance or medically intractable epilepsy. Postoperatively, most patients required continuous anti-epileptic medication, 10 recurrences or tumour progressions of incompletely removed or merely biopsied lesions were observed within the mean follow-up period of 22 months. All recurrences after gross total removal, that were reoperated, had progressed to a malignant glioma. Of the prognostic tumour characteristics analysed, a histologically well-delineated tumour demarcation was most clearly associated with a favourable prognosis. Concerning treatment modalities, gross total resection was associated with a favourable prognosis. Radiotherapy was associated with an unfavourable outcome but this is probably due to selection of otherwise unfavourable cases.
对1984年至1988年间接受手术的50例成人幕上低级别星形细胞瘤患者的术后情况和无进展生存期进行了回顾性分析。排除了毛细胞性病变。32例肿瘤在宏观上完全切除，4例部分切除。14例仅进行了立体定向活检。10例患者术后接受了55至65 Gy的放疗。1例患者围手术期死于肺栓塞。39例患者出院后能够恢复之前的活动，10例因神经功能缺损、神经心理表现下降或药物难治性癫痫而严重致残。术后，大多数患者需要持续服用抗癫痫药物，在平均22个月的随访期内，观察到10例未完全切除或仅活检的病变出现复发或肿瘤进展。所有全切后复发且再次手术的病例均已进展为恶性胶质瘤。在分析的预后肿瘤特征中，组织学上界限清楚的肿瘤边界与良好的预后最明显相关。关于治疗方式，全切与良好的预后相关。放疗与不良结局相关，但这可能是由于选择了其他预后不良的病例。
