Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Department of Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Clin Neurol Neurosurg. 2020 Sep;196:105973. doi: 10.1016/j.clineuro.2020.105973. Epub 2020 May 29.
The role of operation for patients with recurrent diffuse low-grade glioma (DLGG) is controversial. A few studies compared the effectiveness between surgery and other treatments for those patients. We did a systematic review for the effects of reoperation for recurrent DLGG. We searched the following databases from 1990 to 2018: Medline, Cochrane Library, Scopus and Opengrey, including researches about reoperation for recurrent DLGG, regardless of comparison and study design. The Newcastle-Ottawa scale (NOS) was used for quality assessment. Ten studies with 358 participants met the criteria. Due to lack of survival data about non-operated group, we failed to analyze the effect of reoperation. The risk bias of included studies was acceptable except the comparability. However, we found 48.4 % (155/320) of patients underwent gross resection and the safety was acceptable. About 1/3 received adjuvant therapy and 41.9 % (125/298) got histologically progressed. In a word, few studies reported the survival data of recurrent DLGG patients received reoperation. Most were young adults and half of them experienced a histological progress. But there are still a lot of shortages of the existing studies and more researches on the reoperation efficacy in recurrent DLGG are needed.
手术在复发性弥漫性低级别胶质瘤（DLGG）患者中的作用存在争议。有几项研究比较了手术与其他治疗方法对这些患者的疗效。我们对复发性 DLGG 再手术的效果进行了系统评价。我们从 1990 年到 2018 年在以下数据库中进行了检索：Medline、Cochrane 图书馆、Scopus 和 Opengrey，包括关于复发性 DLGG 再手术的研究，无论是否进行比较和研究设计。使用纽卡斯尔-渥太华量表（NOS）进行质量评估。符合标准的有 10 项研究，共 358 名参与者。由于缺乏未手术组的生存数据，我们无法分析再手术的效果。除可比性外，纳入研究的风险偏倚是可以接受的。然而，我们发现 48.4%（155/320）的患者接受了大体全切除，安全性是可以接受的。约有 1/3 的患者接受了辅助治疗，41.9%（125/298）的患者组织学进展。总之，很少有研究报告了接受再手术的复发性 DLGG 患者的生存数据。大多数是年轻人，其中一半经历了组织学进展。但现有研究仍存在诸多不足，需要更多关于复发性 DLGG 再手术疗效的研究。
