Ebeling U, Fischer M, Kothbauer K
Department of Neurosurgery, University of Bern, Inselspital, Switzerland.
Minim Invasive Neurosurg. 1995 Jun;38(2):51-9. doi: 10.1055/s-2008-1053460.
Under local anesthesia, gliomas of the premotor and primary motor cortex can be surgically removed with minimal morbidity. However, since these neoplasms exhibit an infiltrative growth pattern towards the pyramidal tract and are frequently not well delineated from functional motor cortex, the long-term outcome is unfavorable. In this series, 5 of 11 patients presented with a recurrent tumor within two years of operation. Two of these patients with recurrent tumors initially had a low grade glioma and three an anaplastic glioma. Due to the longer progression-free interval after surgery and the unpredictable course of patients with low grade gliomas, all efforts should be undertaken to achieve safe and radical resection with the use of intraoperative mapping and monitoring techniques as well as cryo-cut examinations at all tumor border zones to prove radicality. Since malignant tumors are known to recur in most instances, radical resection is justified only in functionally safe areas.
在局部麻醉下，运动前区和初级运动皮层的胶质瘤可以通过手术切除，且发病率极低。然而，由于这些肿瘤呈现出向锥体束浸润性生长的模式，并且常常与功能性运动皮层界限不清，因此长期预后不佳。在本系列研究中，11例患者中有5例在术后两年内出现肿瘤复发。这5例复发患者中，2例最初为低级别胶质瘤，3例为间变性胶质瘤。鉴于低级别胶质瘤术后无进展生存期较长且病情发展难以预测，应尽一切努力，通过术中图谱绘制和监测技术，以及在所有肿瘤边界区域进行冷冻切片检查以证实切除彻底性，来实现安全且根治性的切除。由于已知大多数情况下恶性肿瘤会复发，根治性切除仅在功能安全区域才是合理的。
