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颅内血管外皮细胞瘤:15例患者的回顾性研究及复发情况的特别分析

Intracranial Hemangiopericytomas : A Retrospective Study of 15 Patients with a Special Review of Recurrence.

作者信息

Noh Sung Hyun, Lim Jae Joon, Cho Kyung Gi

机构信息

Department of Neurosurgery, Bundang CHA Medical Center, CHA University College of Medicine, Seongnam, Korea.

出版信息

J Korean Neurosurg Soc. 2015 Sep;58(3):211-6. doi: 10.3340/jkns.2015.58.3.211. Epub 2015 Sep 30.

Abstract

OBJECTIVE

Although surgical resection is used to treat meningeal hemangiopericytoma (MHPC), there is a high risk of subsequent recurrence. This study investigated factors associated with treatment outcomes and recurrence in patients who had undergone surgical resection of intracranial MHPC.

METHODS

Fifteen patients underwent surgical treatments performed by one senior neurosurgeon between 1997 and 2013. Clinical data, radiologic images, surgical outcomes, recurrence, and other relevant characteristics were reviewed and analyzed.

RESULTS

Fifteen patients were included in the analysis, 12 (80%) of whom had tumors in the supratentorial region, and 3 (20%) of whom had tumors in the infratentorial region. Complete resection was achieved in all 15 patients, and 3 (20%) patients were administered radiosurgery and conventional radiotherapy after surgery as adjuvant radiotherapy. Three patients developed recurrence, 2 of whom had not received adjuvant radiotherapy. In 1 of the patients who had not received adjuvant radiotherapy, recurrence developed at the original tumor site, 81 months after surgery. The other 2 recurrences occurred at other sites, 78 and 41 months after surgery. The 5- and 10-year overall survival rates were 88.3%, while the 5- and 10-year recurrence-free survival rates were 83% and 52%, respectively. Additionally the mean Ki-67 index differed significantly between patients who did and did not develop recurrence (43% vs. 14%; p=0.001).

CONCLUSION

Because of the high risk of MHPC recurrence, MHPC tumors should be completely resected, whenever feasible. However, even when complete resection is achieved, adjuvant radiotherapy might be necessary to prevent recurrence.

摘要

目的

尽管手术切除用于治疗脑膜血管外皮细胞瘤(MHPC),但后续复发风险很高。本研究调查了接受颅内MHPC手术切除患者的治疗结果及复发相关因素。

方法

1997年至2013年间,15例患者接受了由一位资深神经外科医生实施的手术治疗。回顾并分析了临床数据、放射影像、手术结果、复发情况及其他相关特征。

结果

15例患者纳入分析,其中12例(80%)肿瘤位于幕上区域,3例(20%)肿瘤位于幕下区域。15例患者均实现了完全切除,3例(20%)患者术后接受了立体定向放射外科和传统放疗作为辅助放疗。3例患者出现复发,其中2例未接受辅助放疗。在未接受辅助放疗的患者中,1例于术后81个月在原肿瘤部位复发。另外2例复发发生在其他部位,分别在术后78个月和41个月。5年和10年总生存率为88.3%,而5年和10年无复发生存率分别为83%和52%。此外,复发患者与未复发患者的平均Ki-67指数差异显著(43%对14%;p=0.001)。

结论

由于MHPC复发风险高,只要可行,MHPC肿瘤应完全切除。然而,即使实现了完全切除,辅助放疗可能对于预防复发是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5eb/4630351/dbd4560b8f90/jkns-58-211-g001.jpg

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