Department of Neurologic Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, 55905, USA.
Childs Nerv Syst. 2024 Apr;40(4):1031-1044. doi: 10.1007/s00381-023-06239-x. Epub 2023 Dec 19.
Medulloblastoma, the most common malignant brain tumor in children, presents a complex treatment challenge due to its propensity for infiltrative growth within the posterior fossa and its potential attachment to critical anatomical structures. Central to the management of medulloblastoma is the surgical resection of the tumor, which is a key determinant of patient prognosis. However, the extent of surgical resection (EOR), ranging from gross total resection (GTR) to subtotal resection (STR) or even biopsy, has been the subject of extensive debate and investigation within the medical community. Today, the impact of neurosurgical EOR on the prognosis of medulloblastoma patients remains a complex and evolving area of investigation. The conflicting findings in the literature, the challenges posed by critical surrounding anatomical structures, the potential for surgical complications and neurologic morbidity, and the nuanced interactions with molecular subgroups all contribute to the complexity of this issue. As the field continues to advance, the imperative to strike a delicate balance between maximizing resection and preserving quality of life remains central to the management of medulloblastoma patients.
髓母细胞瘤是儿童中最常见的恶性脑肿瘤，由于其在后颅窝内浸润性生长的倾向及其与关键解剖结构的潜在附着，治疗极具挑战性。髓母细胞瘤治疗的核心是肿瘤的手术切除，这是患者预后的关键决定因素。然而，手术切除范围（EOR）从大体全切除（GTR）到次全切除（STR）甚至活检，一直是医学界广泛争论和研究的主题。如今，神经外科 EOR 对髓母细胞瘤患者预后的影响仍然是一个复杂且不断发展的研究领域。文献中的相互矛盾的发现、关键周围解剖结构带来的挑战、手术并发症和神经发病率的可能性，以及与分子亚群的细微相互作用，都增加了这个问题的复杂性。随着该领域的不断发展，在最大限度地切除肿瘤和保持生活质量之间取得微妙平衡仍然是髓母细胞瘤患者管理的核心。
