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中枢神经细胞瘤显微手术切除后的临床结果:一项为期15年的单中心分析

Clinical Outcome After Microsurgical Resection of Central Neurocytoma: A Single-Centre Analysis of 15 Years.

作者信息

Cao Dan, Chen Yong, Guo Zhengqian, Ou Yibo, Chen Jian

机构信息

Department of Neurosurgery, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Neurol. 2021 Dec 22;12:790641. doi: 10.3389/fneur.2021.790641. eCollection 2021.

Abstract

This study aimed to explore the immediate postoperative and long-term outcomes of central neurocytoma (CN) based on 15 years of experience in our institution. This single-institution study collected data of 43 patients with CN who underwent surgery between 2005 and 2020. We reviewed data of clinical, immediate postoperative outcome, and long-term outcome of patients. More specifically, we divided complications into neurological and regional complications groups. Among the 43 patients with CN who underwent surgery, the transcortical (72.1%) or transcallosal (25.6%) approach was used. There were 18 patients (41.9%) who complained about postoperative neurological complications, including motor weakness (25.6%), memory deficit (18.6%), aphasia (7.0%), and seizure (4.7%). In addition, 18 patients suffered postoperative regional complications such as hydrocephalus (2.3%), hematoma (34.9%), infection (4.7%), and subcutaneous hydrops (2.3%). Only one-quarter of patients had suffered permanent surgical complications. The majority of patients recovered from the deficit and could turn back to normal life. There were no significant differences in the clinical outcomes between transcortical and transcallosal approaches. At a median follow-up of 61.8 months, the 5-year overall survival and progression-free survival were 87.0 and 74.0%, respectively. A multivariate Cox model analysis showed that the extent of resection was not related to progression-free survival. However, the extent of resection was significantly associated with overall survival, and gross total resection decreased the risk of death. Patients with CN show favorable outcomes after surgery. The transcortical and transcallosal approaches have similar postoperative complication rates and long-term follow-up outcomes. In terms of long-term prognosis, maximal safety resection should be the first choice of CN.

摘要

本研究旨在基于我们机构15年的经验,探讨中枢神经细胞瘤(CN)的术后即刻及长期预后。这项单机构研究收集了2005年至2020年间43例行手术治疗的CN患者的数据。我们回顾了患者的临床、术后即刻及长期预后数据。更具体地说,我们将并发症分为神经并发症和局部并发症组。在43例行手术治疗的CN患者中,采用经皮质(72.1%)或经胼胝体(25.6%)入路。有18例患者(41.9%)抱怨术后出现神经并发症,包括运动无力(25.6%)、记忆缺陷(18.6%)、失语(7.0%)和癫痫发作(4.7%)。此外,18例患者出现术后局部并发症,如脑积水(2.3%)、血肿(34.9%)、感染(4.7%)和皮下积液(2.3%)。只有四分之一的患者出现永久性手术并发症。大多数患者的功能缺陷得以恢复,并能回归正常生活。经皮质和经胼胝体入路的临床预后无显著差异。中位随访61.8个月时,5年总生存率和无进展生存率分别为87.0%和74.0%。多因素Cox模型分析显示,切除范围与无进展生存率无关。然而,切除范围与总生存率显著相关,全切可降低死亡风险。CN患者术后预后良好。经皮质和经胼胝体入路的术后并发症发生率和长期随访结果相似。就长期预后而言,最大安全切除应作为CN的首选治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f79/8727338/1403ddd4f096/fneur-12-790641-g0001.jpg

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