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脉络丛肿瘤的治疗:来自一家三甲医院的综合研究。

Management of choroid plexus tumours: A comprehensive study from a tertiary hospital.

机构信息

Department of Neurosurgery, NIMHANS, Bangalore, India.

Department of Neurosurgery, NIMHANS, Bangalore, India.

出版信息

Clin Neurol Neurosurg. 2021 Feb;201:106454. doi: 10.1016/j.clineuro.2020.106454. Epub 2021 Jan 6.

Abstract

OBJECTIVE

Choroid plexus tumours (CPT) are rare intraventricular tumours representing less than 0.5 % of brain tumours. The tumour is commonly located in the supratentorial region, but the location varies depending on the age. We present our experience of managing these tumours in a tertiary hospital.

METHODS

Retrospectively, we reviewed our operative database and recruited 80 cases of CPT who underwent surgical treatment in our institute from 1995 to 2018. We analysed the factors affecting the outcome and the perioperative complications of the choroid plexus tumour.

RESULTS

A total of 80 choroid plexus tumours were recruited in our retrospective review, of which 44 were choroid plexus papilloma (CPP), 13 were atypical choroid plexus tumours (ACPP), 23 were choroid plexus carcinomas (CPC). The mean age was 16.75 (SD 16.71) in the overall cohort. Males were found to be predominant in all tumour groups (M/F: 46/34). Headache was the most common symptom (52.5 %). Hydrocephalus was seen in 53.8 % of cases. The median overall survival was 89.88 months. Gross total resection was achieved in 62.5 % cases (n = 50/80), and near-total resection in 27. 5 % cases (n = 22/80). The median overall survival was 89.88 months. The median overall survival for CPP, ACPP, CPC was 106.83, 37.37, 36.19 months, respectively. Median Event-free survival was 65.83 months. A Cox regression analysis of predictors of overall survival of atypical CPP and CPC was done, in which age, sex, location, size, the extent of the resection, and complications were considered. The extent of the resection (p = 0.01) and the size (p = 0.02) were related to overall survival CONCLUSION: CPT's are the rare intraventricular tumours, which requires aggressive resection strategies. The extent of resection offers survival benefit based on the histological grades.

摘要

目的

脉络丛肿瘤(choroid plexus tumours,CPT)是一种罕见的脑室肿瘤,占脑肿瘤的比例不到 0.5%。肿瘤通常位于幕上区域,但位置因年龄而异。我们介绍了在一家三级医院管理这些肿瘤的经验。

方法

回顾性地,我们查阅了我们的手术数据库,并招募了 1995 年至 2018 年在我院接受手术治疗的 80 例 CPT 患者。我们分析了影响脉络丛肿瘤结局和围手术期并发症的因素。

结果

在我们的回顾性研究中,共招募了 80 例脉络丛肿瘤患者,其中 44 例为脉络丛乳头瘤(choroid plexus papilloma,CPP),13 例为非典型脉络丛肿瘤(atypical choroid plexus tumours,ACPP),23 例为脉络丛癌(choroid plexus carcinomas,CPC)。总体队列的平均年龄为 16.75(标准差 16.71)。所有肿瘤组中男性均占优势(M/F:46/34)。头痛是最常见的症状(52.5%)。53.8%的病例出现脑积水。中位总生存期为 89.88 个月。62.5%的病例(n=50/80)实现了大体全切除,27.5%的病例(n=22/80)实现了近全切除。中位总生存期为 89.88 个月。CPP、ACPP、CPC 的中位总生存期分别为 106.83、37.37、36.19 个月。中位无事件生存期为 65.83 个月。对非典型 CPP 和 CPC 的总生存预测因素进行了 Cox 回归分析,其中考虑了年龄、性别、位置、大小、切除范围和并发症。切除范围(p=0.01)和大小(p=0.02)与总生存有关。

结论

CPT 是罕见的脑室肿瘤,需要积极的切除策略。根据组织学分级,切除范围提供生存获益。

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