Posts Tagged ‘Survival’
Ahead of Print: Residual Fluorescence Value in Glioblastomas
Background: There is evidence in the literature that supports fluorescent tissue signal in fluorescence guided surgery (FGS) extends farther than tissue highlighted in T1Gd MRI, which is the standard to quantify the extent of resection (EOR).
Objective: To study whether the presence of residual fluorescent tissue after surgery carries a different prognosis for glioblastoma (GBM) cases with complete resection confirmed by MRI.
Methods: A retrospective review in our center found 118 consecutive patients with high-grade gliomas operated using 5-aminolevulinic acid (5-ALA) FGS. Within that series, the 52 patients with newly diagnosed GBM and complete resection of enhancing tumor (CRET) in early MRI were selected for analysis. We studied the influence of residual fluorescence in the surgical field on overall survival and neurological complication rate. Multivariate analysis included potential relevant factors: age, Karnofsky Performance Scale (KPS), MGMT methylation promoter status, tumor eloquent location, preoperative tumor volume, and adjuvant therapy.
Free CME Article: Meningioma Outcome Hypoxia Biomarkers
Background: The natural history of surgically treated intracranial meningiomas can be quite variable. Recurrence and patient outcome cannot currently be predicted with accuracy.
Objective: To explore the potential roles of tumor hypoxia-regulated biological markers, preoperative imaging, measures of proliferation, and angiogenesis in predicting patient outcome.
Methods: Tissue from 263 patients (average follow-up, 75 months) was examined for molecular markers hypoxia-inducible factor-1α (HIF-1α), carbonic anhydrase-IX (CA-IX), and glucose transporter-1 (Glut-1); vascular endothelial growth factor (VEGF); proliferation (MIB-1); and microvascular density (MVD) (Factor VIII). Preoperative magnetic resonance images were also examined for tumor size and peritumoral brain edema (PTBE).
Ahead of Print: Neurosurgical Management and Prognosis of Patients with Glioblastoma that Progress During Bevacizumab Treatment
Full article access for Neurosurgery subscribers at Neurosurgery-Online.com.
BACKGROUND: The management and prognosis of glioblastoma patients after Stupp protocol treatment and progression during bevacizumab (BV) treatment remains undefined.
OBJECTIVE: We compared the morbidity and survival of patients whose glioblastomas progressed during bevacizumab treatment requiring craniotomy to non-bevacizumab-treated patients.
METHODS: We retrospectively reviewed patients who underwent craniotomy for recurrent glioblastoma from 2005-2009. Patients operated on for progression during bevacizumab (preoperative bevacizumab) were compared to patients receiving no bevacizumab or bevacizumab after surgery (postoperative bevacizumab). Preoperative bevacizumab patients were compared to those progressing on bevacizumab but not operated on (no surgery).
Free Article: Seizures and the Natural History of World Health Organization Grade II Gliomas: A Review
OBJECTIVE: The majority of adults with low-grade gliomas have seizures. Despite the frequency of seizures as initial symptoms and symptoms of later disease, seizures in relation to the natural course of low-grade gliomas have received little attention.
METHODS: In this review, we provide an update of the literature on the prognostic impact of preoperative seizures and discuss the tumor- and treatment-related factors affecting seizure control at later stages of the disease.
Editor Choice: Surgical Mortality at 30 Days and Complications Leading to Recraniotomy in 2630 Consecutive Craniotomies for Intracranial Tumors
Full article access for Neurosurgery subscribers.
BACKGROUND: In order to weigh the risks of surgery against the presumed advantages, it is important to have specific knowledge about complication rates.
OBJECTIVE: To study the surgical mortality and rate of reoperations for hematomas and infections after intracranial surgery for brain tumors in a large, contemporary, single-institution consecutive series.
METHODS: All adult patients from a well-defined population of 2.7 million inhabitants who underwent craniotomies for intracranial tumors at Oslo University Hospital from 2003 to 2008 were included (n = 2630). The patients were identified from our prospectively collected database and their charts studied retrospectively. Follow-up was 100%.
