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儿童脉络丛肿瘤:80 年(1939-2020)连续单机构系列 59 例患者的长期随访。

Choroid Plexus Tumors in Children: Long-Term Follow-Up of Consecutive Single-Institutional Series of 59 Patients Treated over a Period of 8 Decades (1939-2020).

机构信息

Department of Neurosurgery, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.

Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.

出版信息

World Neurosurg. 2022 Feb;158:e810-e819. doi: 10.1016/j.wneu.2021.11.070. Epub 2021 Nov 22.

DOI:10.1016/j.wneu.2021.11.070
PMID:34823041
Abstract

OBJECTIVE

To present long-term follow-up of a consecutive single-institutional series of patients treated for choroid plexus tumors over 8 decades.

METHODS

From 1939 to 2020, 59 children were treated for choroid plexus tumors. Median age at diagnosis was 1.7 years.

RESULTS

Gross total resection was achieved in 51 patients (86%). Ten patients (17%) underwent >1 resection. During the first 4 decades of the study (1939-1979), 14 patients with plexus papillomas were treated. Operative mortality was 50%, with 6 of the remaining 7 patients experiencing excellent survival with follow-up periods of 41-81 years. In the last 4 decades (1980-2020), 38 patients had low-grade tumors, and all were alive at the latest follow-up (range, 0.5-39 years). Observed 5-year survival in this subgroup was 100% (n = 30), as was observed 10-year survival (n = 26). One of 7 (14%) patients with atypical choroid plexus papilloma and 3 of 31 patients (10%) with choroid plexus papilloma underwent a second resection owing to recurrent tumor. At last follow-up, 47 patients (80%) were alive; 45 (96%) had a Barthel Index score of 100 and 2 had a Barthel Index score of 50. Today 25 patients are adults (20-59 years old); 17 work full-time, 4 work part-time, and 4 are unable to work.

CONCLUSIONS

Low-grade choroid plexus tumors can be cured with gross total resection alone, with excellent long-term survival and functionality. The vast majority of survivors live independently as adults and work full-time. Recurrences are uncommon (8.7%), appear within the first few years after primary surgery, and can be treated with repeat resections.

摘要

目的

介绍一个连续的单机构系列患者的长期随访结果,这些患者在 8 个多十年中接受了脉络丛肿瘤的治疗。

方法

从 1939 年至 2020 年,59 名儿童因脉络丛肿瘤接受治疗。诊断时的中位年龄为 1.7 岁。

结果

51 名患者(86%)实现了大体全切除。10 名患者(17%)接受了>1 次切除。在研究的前 40 年(1939-1979 年),14 名患者患有脉络丛乳头瘤。手术死亡率为 50%,其余 7 名患者中有 6 名生存良好,随访时间为 41-81 年。在过去的 40 年(1980-2020 年)中,38 名患者患有低级别肿瘤,截至最新随访时,所有患者均存活(0.5-39 年)。该亚组的 5 年生存率为 100%(n=30),10 年生存率为 100%(n=26)。1 名(14%)非典型脉络丛乳头瘤患者和 3 名(10%)脉络丛乳头瘤患者因肿瘤复发而接受了第二次切除。最后一次随访时,47 名患者(80%)存活;45 名(96%)患者的巴氏指数评分为 100,2 名患者的巴氏指数评分为 50。现在有 25 名患者为成年人(20-59 岁);17 名全职工作,4 名兼职工作,4 名无法工作。

结论

低级别脉络丛肿瘤可以通过大体全切除治愈,具有良好的长期生存和功能。绝大多数幸存者作为成年人独立生活并全职工作。复发并不常见(8.7%),出现在初次手术后的最初几年内,可以通过再次切除进行治疗。

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