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中枢神经系统的脑膜乳头状瘤:SEER 数据库分析。

Papillary meningioma of the central nervous system: a SEER database analysis.

机构信息

Department of Neurosurgery, West China Hospital, Sichuan University, Guoxue Alley 37, Chengdu, 610041, Sichuan, China.

出版信息

Neurosurg Rev. 2021 Oct;44(5):2777-2784. doi: 10.1007/s10143-020-01449-2. Epub 2021 Jan 8.

Abstract

Papillary meningioma (PM) is a rare central nervous system tumor. We aimed to analyze the characteristics and outcomes of patients with PM (WHO grade III) and identify risk factors that influence survival using the Surveillance, Epidemiology, and End Results (SEER) database. Clinical characteristics, tumor features, and outcomes of 108 PM patients included in the SEER database between 1990 and 2016 were retrieved. Risk factors related to prognosis of PM were assessed by Kaplan-Meier curves and the Cox proportional hazards model. All 108 patients, including 65 males and 43 females (1.5:1), with a median age of 52 years (range, 9 to > 85 years) had undergone surgical resection. Gross total resection (GTR) was achieved in 50%, and 50% underwent subtotal resection (STR). While 55.6% underwent postoperative radiation therapy, 48% did not. The median disease-specific survival (DSS) was 128 months, and the 5-year DSS rate was 77%. In multivariate analysis, age ≤ 52 years and GTR were both independently associated with higher probability of DSS (p = 0.033 and p = 0.029, respectively). Stratification analysis showed that postoperative radiotherapy had no significant impact on the DSS, irrespective of resection extent (p = 0.172). Our SEER analysis showed that age and extent of resection were prognostic factors for PM, but race, tumor size, gender, chemotherapy, and postoperative radiotherapy did not significantly impact DSS of PM patients. There was no significant improvement in survival of patients who underwent radiotherapy and GTR, or radiotherapy and STR, compared with GTR or STR alone.

摘要

脑膜乳头状瘤(PM)是一种罕见的中枢神经系统肿瘤。我们旨在通过监测、流行病学和最终结果(SEER)数据库分析 PM(WHO 分级 III)患者的特征和结局,并确定影响生存的危险因素。从 1990 年至 2016 年,SEER 数据库中纳入了 108 例 PM 患者的临床特征、肿瘤特征和结局。通过 Kaplan-Meier 曲线和 Cox 比例风险模型评估与 PM 预后相关的危险因素。所有 108 例患者中,包括 65 例男性和 43 例女性(1.5:1),中位年龄为 52 岁(范围:9 岁至>85 岁),均接受了手术切除。50%实现了大体全切除(GTR),50%行次全切除(STR)。55.6%接受了术后放疗,48%未接受放疗。中位疾病特异性生存(DSS)为 128 个月,5 年 DSS 率为 77%。多因素分析显示,年龄≤52 岁和 GTR 均与更高的 DSS 概率独立相关(p=0.033 和 p=0.029)。分层分析显示,无论切除范围如何,术后放疗对 DSS 均无显著影响(p=0.172)。我们的 SEER 分析表明,年龄和切除范围是 PM 的预后因素,但种族、肿瘤大小、性别、化疗和术后放疗对 PM 患者的 DSS 无显著影响。与单独 GTR 或 STR 相比,接受放疗和 GTR 或放疗和 STR 的患者的生存并未显著改善。

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