Retrospective autoevaluation of the results of intrinsic brain tumor surgeries – consecutive cohort of 270 surgeries within one neurosurgical center of the NOS ČOS (Neurooncological section of the Czech Oncology Society) from 2015–2017


Authors: R. Bartoš 1,2;  D. Ospalík 3;  A. Malucelli 1;  P. Vachata 1;  M. Sameš 1;  T. Kazda 4,5;  D. Šmejkalová-Musilová 6;  F. Třebický 7
Authors‘ workplace: Neurochirurgická klinika UJEP, a Masarykova nemocnice, KZ a. s., Ústí, nad Labem 1;  Anatomický ústav, 1. LF UK, Praha 2;  Neurologické oddělení, Masarykova, nemocnice, KZ a. s., Ústí nad Labem 3;  Klinika radiační onkologie Masarykova, onkologického ústavu, Brno 4;  Klinika radiační onkologie LF MU, Brno 5;  Onkologické oddělení, Komplexní, onkologické centrum, Masarykova, nemocnice, KZ a. s., Ústí nad Labem 6;  Ústav radiační onkologie, Nemocnice, na Bulovce, Praha 7
Published in: Cesk Slov Neurol N 2019; 82(4): 401-409
Category: Original Paper
doi: 10.14735/amcsnn2019401

Overview

Aim: Retrospective evaluation of a consecutive cohort of adult intrinsic brain tumor patients operated in Ústí nad Labem (Czech Republic) from 2015 to 2017 focusing on the assessment of postoperative morbidity.

Patients and Methods: Basic evaluated variables included neurological morbidity, subgaleal cerebrospinal fluid collection or duration of hospitalization. In the subgroup of patients with high-grade gliomas, the parameters of the organization of subsequent oncological care, such as the waiting time until the start of radiotherapy were evaluated, together with overall survival estimations.

Results: A total of 270 surgeries were performed (average age 60 years, 59% men). Newly dia­gnosed glioblastomas (GBM) represented 37.4% of the surgeries, while metastases were 32.6% of the total. Severe neurological morbidity was observed in 18 patients (6.7%). Subgaleal cerebrospinal fluid collection was dia­gnosed in 13% of patients. The average length of hospitalization was 6.6 days. About 30% of patients underwent complete oncological treatment. The median waiting time for radiotherapy was 46 days after surgery (no effect on overall survival). The median overall survival of patients with GBM was 8.8 months (95% CI 2.2–13.4). Significantly longer overall survival was observed in patients who were able to undergo treatment according to the Stupp regimen (22.6 vs. 4.3 months, P < 0.001), those after resection vs. bio­psy (12.4 vs. 4 months, P < 0.001) and younger patients ≤ 60 years (19.4 vs. 5.1 months, P < 0.001).

Conclusion: We observed overall low postoperative morbidity in our cohort of neurooncology patients. Self-evaluation of results is an integral part of complex neurosurgical care.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


内在性脑肿瘤手术结果的回顾性自动评估– 2015年至2017年,在NOSČOS(捷克肿瘤学会神经病学分会)的一个神经外科中心内连续进行270例手术

目的:回顾性评估2015年至2017年在Ústí nad Labem(捷克共和国)进行的成年内在脑肿瘤患者的队列研究,重点是评估术后发病率。

患者和方法:评估的基本变量包括神经疾病发病率、枕下脑脊液收集或住院时间。在高级别胶质瘤患者的亚组中,评估了后续肿瘤护理的组织参数,如放疗开始前的等待时间,以及总体生存评估。

结果:总共进行了270例手术(平均年龄60岁,男性占59%)。新诊断的胶质母细胞瘤(GBM)占手术的37.4%,而转移灶占总数的32.6%。 18例患者(6.7%)出现严重的神经系统疾病。13%的患者被诊断为心下脑脊液收集。平均住院时间为6.6天。大约30%的病人接受了完全的肿瘤治疗。放疗的平均等待时间为术后46天(对总生存率无影响)。GBM患者的中位总生存期为8.8个月(95% CI 2.2-13.4)。能够按照Stupp方案进行治疗的患者的总生存期明显延长(22.6个月vs. 4.3个月,P < 0.001);手术切除与活检(12.4 vs. 4个月,P < 0.001)及≤60岁的年轻患者(19.4 vs. 5.1个月,P < 0.001)。

结论:我们在神经肿瘤患者队列中观察到总体的术后发病率较低。结果的自我评估是复杂的神经外科护理不可或缺的一部分。
关键词:神经肿瘤–脑肿瘤–放射治疗

Keywords:

neurooncology – brain tumor – radiotherapy


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Paediatric neurology Neurosurgery Neurology

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