Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, People's Republic of China; The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, People's Republic of China; Nanfang Glioma Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, People's Republic of China.
Nanfang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, People's Republic of China.
Clin Neurol Neurosurg. 2021 Dec;211:107015. doi: 10.1016/j.clineuro.2021.107015. Epub 2021 Nov 6.
Frontal glioma frequently invaded the subventricular zone (SVZ), which existed glioma stem cells and might be involved in the development of primary and recurrent gliomas. We attempted to identify whether ventricle wall resection contributed to the maximal extent of resection (EOR) and increased the patient's survival during frontal glioma resection.
A total of 151 adult patients with primary SVZ-involved frontal gliomas were obtained between January 2012 and December 2018. We analyzed clinical data, EOR, complications and survival profiles between the ventricle wall group and the ventricle intact/opening group.
Applying ventricle wall removal had similar effect on the improvement of neurological function compared to applying ventricle intact/opening and did not increase the incidence of new neurological deficits, hydrocephalus, and ependymal dissemination in SVZ-involved frontal gliomas. A positive correlation was identified between EOR and the ventricle wall handling (r = 0.487, P < 0.001), which indicated that ventricle wall resection could contribute to achieve supramaximal resection. Applying supramaximal resection and ventricle wall resection could significantly prolong overall survival and progression free survival. Ventricle wall resection could be regarded as an independent prognostic indicator for both overall survival and progression free survival in patients with SVZ-involved frontal gliomas.
Ventricle wall resection in SVZ-involved frontal gliomas could contribute to achieve supramaximal resection and could significantly prolong overall survival and progression free survival.
额部脑胶质瘤常侵犯侧脑室下区（SVZ），其中存在胶质瘤干细胞，可能参与原发性和复发性脑胶质瘤的发生发展。我们试图确定脑室壁切除是否有助于最大限度地切除肿瘤（EOR）并提高额部脑胶质瘤切除患者的生存率。
本研究共纳入了 2012 年 1 月至 2018 年 12 月期间收治的 151 例原发性 SVZ 受累的额部脑胶质瘤患者。我们分析了脑室壁组和脑室完整/开放组之间的临床资料、EOR、并发症和生存情况。
与脑室完整/开放组相比，应用脑室壁切除对改善神经功能的效果相似，且不会增加新的神经功能缺损、脑积水和 SVZ 受累的额部脑胶质瘤的室管膜播散的发生率。EOR 与脑室壁处理呈正相关（r=0.487，P<0.001），这表明脑室壁切除有助于实现最大程度的切除。采用最大程度的切除和脑室壁切除可显著延长总生存期和无进展生存期。脑室壁切除可作为 SVZ 受累的额部脑胶质瘤患者总生存期和无进展生存期的独立预后指标。
SVZ 受累的额部脑胶质瘤的脑室壁切除有助于实现最大程度的切除，并可显著延长总生存期和无进展生存期。
