Hoffmann-Wieker Carola Marie, Rebelo Artur, Moll Martin, Ronellenfitsch Ulrich, Rengier Fabian, Erhart Philipp, Böckler Dittmar, Ukkat Jörg
Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany.
Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), 06097 Halle (Saale), Germany.
Diagnostics (Basel). 2023 Feb 15;13(4):744. doi: 10.3390/diagnostics13040744.
To analyze the association of tumor volume with outcome after surgery for cervical paraganglioma. This retrospective study included consecutive patients undergoing surgery for cervical paraganglioma from 2009-2020. Outcomes were 30-day morbidity, mortality, cranial nerve injury, and stroke. Preoperative CT/MRI was used for tumor volumetry. An association between the volume and the outcomes was explored in univariate and multivariable analyses. A receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated. The study was conducted and reported according to the STROBE statement. Volumetry was successful in 37/47 (78.8%) of included patients. A 30-day morbidity occurred in 13/47 (27.6%) patients with no mortality. Fifteen cranial nerve lesions occurred in eleven patients. The mean tumor volume was 6.92 cm in patients without and 15.89 cm in patients with complications ( = 0.035) and 7.64 cm in patients without and 16.28 cm in patients with cranial nerve injury ( = 0.05). Neither the volume nor Shamblin grade was significantly associated with complications on multivariable analysis. The AUC was 0.691, indicating a poor to fair performance of volumetry in predicting postoperative complications. Surgery for cervical paraganglioma bears a relevant morbidity with a particular risk of cranial nerve lesions. Tumor volume is associated with morbidity, and MRI/CT volumetry can be used for risk stratification.
分析颈副神经节瘤手术后肿瘤体积与预后的相关性。这项回顾性研究纳入了2009年至2020年连续接受颈副神经节瘤手术的患者。观察指标为30天发病率、死亡率、颅神经损伤和中风。术前CT/MRI用于肿瘤体积测量。在单变量和多变量分析中探讨体积与预后之间的关联。绘制受试者工作特征（ROC）曲线，并计算曲线下面积（AUC）。本研究按照STROBE声明进行并报告。在纳入的47例患者中，37例（78.8%）成功进行了体积测量。13/47例（27.6%）患者发生30天发病率，无死亡病例。11例患者出现15处颅神经损伤。无并发症患者的平均肿瘤体积为6.92 cm，有并发症患者为15.89 cm（P = 0.035）；无颅神经损伤患者为7.64 cm，有颅神经损伤患者为16.28 cm（P = 0.05）。多变量分析显示，体积和Shamblin分级均与并发症无显著相关性。AUC为0.691，表明体积测量在预测术后并发症方面表现较差至中等。颈副神经节瘤手术有一定的发病率，尤其有颅神经损伤的风险。肿瘤体积与发病率相关，MRI/CT体积测量可用于风险分层。
