Wang Meiyao, Yu Jin, Zhang Jibo, Pan Zhiyong, Chen Jincao
Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
Front Oncol. 2023 Mar 23;13:1161496. doi: 10.3389/fonc.2023.1161496. eCollection 2023.
Reoperation may be beneficial for patients with recurrent gliomas. Minimizing the residual tumor volume (RTV) while ensuring the functionality of relevant structures is the goal of the reoperation of recurrent gliomas. Intraoperative ultrasound (IoUS) may be helpful for intraoperative tumor localization, intraoperative real-time imaging to guide surgical resection, and postoperative evaluation of the RTV in the reoperation for recurrent gliomas.
To assess the effect of real-time ioUS on minimizing RTV in recurrent glioma surgery compared to Non-ioUS.
We retrospectively analyzed the data from 92 patients who had recurrent glioma surgical resection: 45 were resected with ioUS guidance and 47 were resected without ioUS guidance. RTV, Karnofsky Performance Status (KPS) at 6 months after the operation, the number of recurrent patients, and the time to recurrence were evaluated.
The average RTV in the ioUS group was significantly less than the Non-ioUS group (0.27 cm vs. 1.33 cm, p = 0.0004). Patients in the ioUS group tended to have higher KPS scores at 6 months of follow-up after the operation than those in the Non-ioUS group (70.00 vs. 60.00, p = 0.0185). More patients in the Non-ioUS group experienced a recurrence than in the ioUS group (43 (91.49%) vs. 32 (71.11%), p = 0.0118). The ioUS group had a longer mean time to recurrence than the Non-ioUS group (7.9 vs. 6.3 months, p = 0.0013).
The use of ioUS-based real-time for resection of recurrent gliomas has been beneficial in terms of both RTV and postoperative outcomes, compared to the Non-ioUS group.
再次手术可能对复发性胶质瘤患者有益。在确保相关结构功能的同时，尽量减少残留肿瘤体积（RTV）是复发性胶质瘤再次手术的目标。术中超声（IoUS）可能有助于术中肿瘤定位、术中实时成像以指导手术切除以及复发性胶质瘤再次手术中RTV的术后评估。
评估与非IoUS相比，实时IoUS对复发性胶质瘤手术中最小化RTV的效果。
我们回顾性分析了92例行复发性胶质瘤手术切除患者的数据：45例在IoUS引导下切除，47例在无IoUS引导下切除。评估RTV、术后6个月的卡氏功能状态评分（KPS）、复发患者数量和复发时间。
IoUS组的平均RTV显著低于非IoUS组（0.27 cm对1.33 cm，p = 0.0004）。IoUS组患者在术后6个月随访时的KPS评分往往高于非IoUS组（70.00对60.00，p = 0.0185）。非IoUS组复发的患者比IoUS组更多（43例（91.49%）对32例（71.11%），p = 0.0118）。IoUS组的平均复发时间比非IoUS组长（7.9个月对6.3个月，p = 0.0013）。
与非IoUS组相比，基于IoUS的实时技术用于复发性胶质瘤切除在RTV和术后结果方面均有益。
