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影像学而非临床变量指导胶质母细胞瘤患者的手术方案。

Radiological and Not Clinical Variables Guide the Surgical Plan in Patients with Glioblastoma.

机构信息

Department of Medical Oncology, Hospital Universitario de Canarias, 38320 La Laguna, Spain.

Department of Neurosurgery, Hospital Universitario de Canarias, 38320 La Laguna, Spain.

出版信息

Curr Oncol. 2024 Apr 1;31(4):1899-1912. doi: 10.3390/curroncol31040142.


DOI:10.3390/curroncol31040142
PMID:38668045
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11049408/
Abstract

: The extent of resection is the most important prognostic factor in patients with glioblastoma. However, the factors influencing the decision to perform a biopsy instead of maximal resection have not been clearly established. The aim of this study was to analyze the factors associated with the intention to achieve maximal resection in glioblastoma patients. : A retrospective single-center case-series analysis of patients with a new diagnosis of glioblastoma was performed. Patients were distributed into two groups: the biopsy (B) and complete resection (CR) groups. To identify factors associated with the decision to perform a B or CR, uni- and multivariate binary logistic regression analyses were performed. Cox regression analysis was also performed in the B and CR groups. : Ninety-nine patients with a new diagnosis of glioblastoma were included. Sixty-eight patients (68.7%) were treated with CR. Ring-enhancement and edema volume on presurgical magnetic resonance imaging were both associated with CR. Corpus callosum involvement and proximity to the internal capsule were identified as factors associated with the decision to perform a biopsy. In the multivariate analysis, edema volume (OR = 1.031; = 0.002) and proximity to the internal capsule (OR = 0.104; = 0.001) maintained significance and were considered independent factors. In the survival analysis, only corpus callosum involvement (HR = 2.055; = 0.035) and MGMT status (HR = 0.484; = 0.027) presented statistical significance in the CR group. : The volume of edema and proximity to the internal capsule were identified as independent factors associated with the surgical decision. The radiological evaluation and not the clinical situation of the patient influences the decision to perform a biopsy or CR.

摘要

: 切除范围是胶质母细胞瘤患者最重要的预后因素。然而,影响行活检而非最大程度切除的决策的因素尚未明确。本研究旨在分析与胶质母细胞瘤患者最大程度切除意向相关的因素。: 对新诊断为胶质母细胞瘤的患者进行了回顾性单中心病例系列分析。患者分为两组:活检(B)组和完全切除(CR)组。为了确定与行 B 或 CR 决策相关的因素,进行了单变量和多变量二项逻辑回归分析。还对 B 组和 CR 组进行了 Cox 回归分析。: 共纳入 99 例新诊断为胶质母细胞瘤的患者。68 例患者(68.7%)接受了 CR 治疗。术前磁共振成像上的环形增强和水肿体积均与 CR 相关。胼胝体受累和靠近内囊被确定为与行活检决策相关的因素。在多变量分析中,水肿体积(OR=1.031;=0.002)和靠近内囊(OR=0.104;=0.001)具有显著性,并被认为是独立因素。在生存分析中,只有胼胝体受累(HR=2.055;=0.035)和 MGMT 状态(HR=0.484;=0.027)在 CR 组具有统计学意义。: 水肿体积和靠近内囊被确定为与手术决策相关的独立因素。放射学评估而非患者的临床情况影响行活检或 CR 的决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cb8/11049408/4abbe8c234e4/curroncol-31-00142-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cb8/11049408/baabbaffea00/curroncol-31-00142-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cb8/11049408/4abbe8c234e4/curroncol-31-00142-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cb8/11049408/baabbaffea00/curroncol-31-00142-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cb8/11049408/4abbe8c234e4/curroncol-31-00142-g002.jpg

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[9]
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引用本文的文献

[1]
Prognostic evaluation in recurrent glioma through C-Choline PET/CT imaging.

EJNMMI Res. 2024-9-12

本文引用的文献

[1]
Navigated Intraoperative 3D Ultrasound in Glioblastoma Surgery: Analysis of Imaging Features and Impact on Extent of Resection.

Front Neurosci. 2022-5-9

[2]
Decision making and surgical modality selection in glioblastoma patients: an international multicenter survey.

J Neurooncol. 2022-2

[3]
Association of Neurological Impairment on the Relative Benefit of Maximal Extent of Resection in Chemoradiation-Treated Newly Diagnosed Isocitrate Dehydrogenase Wild-Type Glioblastoma.

Neurosurgery. 2022-1-1

[4]
CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2014-2018.

Neuro Oncol. 2021-10-5

[5]
Glioblastoma: clinical presentation, diagnosis, and management.

BMJ. 2021-7-14

[6]
Impact of surgical resection of butterfly glioblastoma on survival: a meta-analysis based on comparative studies.

Sci Rep. 2021-7-6

[7]
Fluorescence-Guided Surgery for High-Grade Gliomas: State of the Art and New Perspectives.

Technol Cancer Res Treat. 2021

[8]
Extent of resection and survival in patients with glioblastoma multiforme: Systematic review and meta-analysis.

Medicine (Baltimore). 2021-6-25

[9]
Intraoperative B-Mode Ultrasound Guided Surgery and the Extent of Glioblastoma Resection: A Randomized Controlled Trial.

Front Oncol. 2021-5-19

[10]
Intraoperative MRI for Brain Tumors.

J Neurooncol. 2021-2

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