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影响实性小脑成血管细胞瘤患者长期预后的相关因素分析

The analysis of correlative factors affecting long-term outcomes in patients with Solid Cerebellar Hemangioblastomas.

作者信息

Niu Liang, Zhang Yinian, Li Qiao, Dai Junqiang, Yin Hang, Duan Lei, Yang Hu, Liang Wentao, Qin Zhenwei, Zhang Jianping, Pan Yawen

机构信息

Department of Neurosurgery, Lanzhou University Second Hospital, China.

Department of Neurosurgery, Lanzhou University Second Hospital, China; Institute of Neurology, Lanzhou University Second Hospital, China.

出版信息

Clin Neurol Neurosurg. 2016 Nov;150:59-66. doi: 10.1016/j.clineuro.2016.08.028. Epub 2016 Aug 29.

Abstract

OBJECTIVE

Analyze the factors affecting postoperative outcomes in patients with solid cerebellar hemangioblastomas.

PATIENTS AND METHODS

We retrospectively analyzed the clinical data of 22 patients with sporadic solid cerebellar hemangioblastomas. Data regarding the clinical materials and imaging features, diameter of the lesion, operative approaches and postoperative complications were analyzed in all patients. The factors that may affect the recovery of postoperative patients were analyzed by univariate analysis and logistic regression multivariate analysis.

RESULTS

All 22 patients were diagnosed with sporadic solid cerebellar hemangioblastomas; total resection was achieved in 21 of 22 patients (95.5%). Six patients with combined obstructive hydrocephalus received a ventricle-peritoneal shunt preoperatively. The mean duration of the follow-up period was 25.5 months (range, 6-72 months). Tumor recurrence occurred in two patients with poor prognosis at 12 months and 56 months after surgery. According to outcome, patients were divided into the poor group (4 of 22 patients, 18.2%), in which neurological symptoms persisted postoperatively, or were worse than preoperatively, and the good group (18 of 22 patients, 81.8%) with no neurological signs or improved symptoms postoperatively. After univariate analysis, the factor affecting the final outcome was postoperative hemorrhage (P=0.003). Moreover, multiple logistic regression analysis via R software indicated that postoperative hemorrhage (p=0.008) was correlated with outcomes.

CONCLUSIONS

Postoperative hemorrhage is a factor correlated with final outcomes of patients with sporadic solid cerebellar hemangioblastomas.

摘要

目的

分析影响实性小脑成血管细胞瘤患者术后结局的因素。

患者与方法

我们回顾性分析了22例散发性实性小脑成血管细胞瘤患者的临床资料。分析了所有患者的临床资料、影像学特征、病变直径、手术方式及术后并发症。通过单因素分析和逻辑回归多因素分析,对可能影响术后患者恢复的因素进行分析。

结果

22例患者均诊断为散发性实性小脑成血管细胞瘤;22例患者中有21例(95.5%)实现了全切。6例合并梗阻性脑积水的患者术前接受了脑室-腹腔分流术。随访期平均时长为25.5个月(范围6 - 72个月)。2例预后较差的患者分别在术后12个月和56个月出现肿瘤复发。根据结局,患者被分为预后较差组(22例患者中的4例,18.2%),这些患者术后神经症状持续存在或比术前更严重;以及预后良好组(22例患者中的18例,81.8%),这些患者术后无神经体征或症状改善。单因素分析后,影响最终结局的因素是术后出血(P = 0.003)。此外,通过R软件进行的多因素逻辑回归分析表明,术后出血(p = 0.008)与结局相关。

结论

术后出血是与散发性实性小脑成血管细胞瘤患者最终结局相关的一个因素。

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