Abstract:
BACKGROUND:Despite decades of therapeutic and molecular refinements, the prognosis of patients with glioblastoma (GBM) still remains unfavorable. Integrative clinical studies allow a better understanding of the natural evolution of GBM. To assess independent predictors of overall survival (OS) and progression free survival (PFS) clinical, surgical, molecular and radiological variables were evaluated. A novel preoperative volumetric magnetic resonance imaging (MRI) index for tumor prognosis in GBM patients was investigated. METHODS:A cohort of 195 cases of patients operated for newly GBM were analyzed. Extent of tumoral resection (EOR), tumor growth pattern, expressed by preoperative volumetric ΔT1-T2 MRI index, molecular markers such as O6-methylguanine-DNA methyltransferase (MGMT) methylation and isocitrate dehydrogenase 1/2 (IDH1/2) mutation, were analyzed. Analysis of survival was done using Cox-proportional hazard models. RESULTS:The 1-, 2- years estimated OS and PFS rate for the whole population were 61% and 27%, 38% and 17%, respectively. A better survival rate, both in terms of survival and tumor progression, was observed in patient with higher EOR (p=0.000), younger age (p=0.000), MGMT methylation status (p=0.001) and lower preoperative ΔT1-T2 MRI index (p=0.004). Regarding the tumor growth pattern a cut-off value of 0.75 was found to discriminate patient with different prognosis. Patients with a preoperative ΔT1-T2 MRI index <0.75 had a 1-year estimated OS of 67%, otherwise patients with a preoperative ΔT1-T2 MRI index >0.75 hada 1-year estimated OS of 34%. CONCLUSIONS:In this investigation longer survival is associated with younger age, EOR, promoter methylation of MGMT and preoperative tumor volumetric features expressed by ΔT1-T2 MRI index. The preoperative ΔT1-T2 MRI index could be a promising prognostic factor potentially useful in GBM management. Future investigations based on multiparametric MRI data and next generation sequences analysis, may better clarify this result.
journal_name
J Neurosurg Scijournal_title
Journal of neurosurgical sciencesauthors
Ius T,Pignotti F,Della Pepa GM,Bagatto D,Isola M,Battistella C,Gaudino S,Pegolo E,Chiesa S,Arcicasa M,La Rocca G,Olivi A,Skrap M,Sabatino Gdoi
10.23736/S0390-5616.20.04850-Xsubject
Has Abstractpub_date
2020-02-04 00:00:00eissn
0390-5616issn
1827-1855pii
S0390-5616.20.04850-Xpub_type
杂志文章abstract:BACKGROUND:The results of randomized trials indicate that carotid endarterectomy, performed with a low morbidity-mortality perioperative risk, is the best therapeutic option both for patients with high-grade symptomatic and asymptomatic stenosis. Since the main operative risk is represented by embolic or hemodynamic ce...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract:INTRODUCTION:To determine the association between magnetic resonance imaging (MRI)-detected vulnerable Carotid Plaques and clinical presentation related to ipsilateral carotid artery territory. EVIDENCE ACQUISITION:We searched three databases including Ovid MEDLINE, Ovid EMBASE, and Scopus from 2000 to 2018 for studie...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.19.04820-3
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The short pars and the narrowed surgical corridor for far lateral L5S1 herniation make the transpars approach challenging. The aim of this study is to determine the feasibility, efficacy and safety of the transpars microscopic approach for the treatment of L5-S1 foraminal and extraforaminal lumbar disc herni...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.20.05165-6
更新日期:2020-12-09 00:00:00
abstract::This is a report of two cases of intramedullary arteriovenous malformations (AVMs) where computed tomography (CT) was used as a complementary diagnostic investigation. CT scan features in these two cases are briefly discussed. ...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Malignant exophthalmos is often not resolvable using only medical or radiation therapy. The pressure on the optic nerve which is generally associated with it evolves rapidly in many cases towards optic atrophy and subsequently loss of vision. Only surgical treatment offers any guarantee of success and of the various t...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::A rare case of complex cerebral arteriovenous fistula in an infant is reported. An 8-month-old boy first presented with a syndrome of increased intracranial pressure. Neuroradiological assessment showed a direct intracerebral arteriovenous shunt with marked venous engorgement. No hemorrhage was evident. Direct surgica...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract:AIM:Deep brain stimulation (DBS) is the treatment of choice for advanced Parkinson's disease. The target co-ordinates are traditionally calculated in relation to the intercommissural distance. Anterior (AC) and posterior commissures (PC) may be visualised by the means of ventriculography, CT or MRI. METHODS:We have st...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2003-03-01 00:00:00
abstract::Spasmodic torticollis (ST) is a puzzling movement disorder, characterized by involuntary tonic or clonic contractions of various neck muscles. From time to time, psychogenic, extrapyramidal and neuroperipheral origins have been postulated and reflecting the variety of theories proposed, as many different treatments ha...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract::Transient sixth cranial nerves palsy may occur in rare cases after lumbar puncture, spinal anesthesia and myelography as well as in more rare cases of spontaneous intracranial hypotension. We report three cases of spontaneous intracranial hypotension with sixth cranial nerves palsy. One of these patients presented als...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::Recent data from phase II trials have shown that lonidamine (LND) is effective in the treatment of tumors of various histogenesis, including gliomas. In the present work, we tested the antiproliferative effect of LND on a human glioblastoma cell line (LI) in different culture conditions. When LI are cultured in their ...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract::Fournier's gangrene is a rare, multi-organism infection of the perineum. The disease is most often confined to the groin area with distant spread being extremely unusual. A ase of spinal epidural abscess as a complication of Fournier's gangrene is presented. The infection appears to have spread by the hematogenous rou...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::The authors report a case of intracranial tumor in a 60 year female, previously asymptomatic presenting with altered sensorium following a road traffic accident. Imaging showed a small left frontotemporal contusion along with a large right frontoparietal extra axial mass lesion suggestive of a meningioma. Patient impr...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2009-12-01 00:00:00
abstract::The Authors report three cases of pseudotumor cerebri with noteworthy visual defect. Lumboperitoneal shunt enables good recovery where there was no atrophy of the optic nerve and demonstrated its usefulness also in serious situations. ...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract::Posterior dynamic stabilization of the lumbar spine is spreading as a viable alternative to spinal fusion, aiming to achieve an equally satisfactory clinical outcome without making the spine completely rigid. We describe the feasibility of a minimally invasive surgical technique used to implant a hybrid system and per...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.17.03950-9
更新日期:2020-12-01 00:00:00
abstract::Long-term ICP monitoring was carried out in 53 children and adolescents with severe head injuries. 36 of them exhibited bilateral decerebrate posturing and 13 bilateral pupil unresponsiveness. The highest ICP levels never exceeded 10 mmHg in 3 patients, ranged between 11 and 20 mmHg in 12 and between 21 and 50 in 16. ...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1982-07-01 00:00:00
abstract::Four cases of acute spontaneous subdural haematoma are described. A review of the literature reveals the rarity of this pathology. The several etiological possibilities are discussed. The clinical onset may simulate other cerebrovascular diseases. The prognosis is correlate to the neurological findings at the operatio...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00
abstract::The association in the same patient between two meningiomas and an astrocytoma of the third ventricle is presented. All tumors were removed in two surgical sessions. The unusual occurrence of such associations, except for the so-called phakomatoses, is emphasized. Other similar cases drawn from the literature are tabl...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract::Primary cerebellar glioblastoma multiforme (GBM) is a rare tumor in adults that accounts for just 1% of all cases of GBM. Cerebellar GBMs are not yet completely understood also as far as the prognosis. We report a case of cerebellar GBM in a 27-year-old woman. Magnetic resonance imaging (MRI) showed a 3x3.6 cm-sized, ...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2012-12-01 00:00:00
abstract::Cardiac complications are frequent in patients with subarachnoid hemorrhage (SAH). They include ECG abnormalities, cardiac arrhythmias, myocardial damage, and neurogenic pulmonary edema. The pathophysiology of these abnormalities is related to an imbalance of the autonomic cardiovascular control and to increased circu...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
doi:
更新日期:1998-03-01 00:00:00
abstract::The filum terminale is an exceptional location for isolated hemangioblastoma. Only five cases are reported in literature, prior to the magnetic resonance imaging era. A 57-year-old man was referred to our Department with a prolonged history of progressive back pain, particularly severe when recumbent, and recurrent un...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract:: ...
journal_title:Journal of neurosurgical sciences
pub_type: 信件
doi:10.23736/S0390-5616.17.04285-0
更新日期:2018-12-01 00:00:00
abstract::Multiple meningiomas in different neuraxial compartments are quite rare. The authors report two new cases of association between cranial and spinal meningiomas, one of them in a patient operated upon for multiple intracranial meningiomas. The first case was a 60-year-old woman with progressive paraparesis who had been...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::A preliminary report on the immunological monitoring of primary intracranial neoplasms is presented. The most important findings concerning B-cells and T-cells mediated immunity and delayed hypersensitivity reactions in this kind of patients, are discussed. Among the fairly significant immunobiological pictures, the A...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract::Intracranial aneurysm in children is a rare pathology. Epidemiological studies have indicated that aneurysms in pediatric age are characterized by predominance in male subjects, a frequent great volume and a prevalently distal localization. It is assumed that these factors prove the traumatic origin (accident or birth...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1997-06-01 00:00:00
abstract::Tumor related fractures of the spine frequently dictate surgical management. The most critical factors influencing the need and type of surgery are degree of epidural cord compression, radiosensitivity of the tumor, presence of spinal instability and patient medical status/ estimated survivorship. There is a wide spec...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
doi:
更新日期:2012-06-01 00:00:00
abstract::The brainstem is an uncommon site for a brain abscess. It accounts for less than 4% of all posterior cranial fossa abscesses, and less than 1% of all intracranial abscesses. The pons is the most common site for these abscesses. The aim of the present report was to describe the case of a Brazilian Amazon man with a bra...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:2011-12-01 00:00:00
abstract::The authors report two clinical trials concerning chemotherapy and immunotherapy combined in the treatment of primary and metastatic brain tumors. In the first study bacillus Calmette-Guerin (BCG) and in the second Levamisole (LMS) were utilized as immunostimulating agents. Chemotherapy was performed with BCNU or CCNU...
journal_title:Journal of neurosurgical sciences
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::A case of a giant aneurysm of the internal carotid artery which ruptured during cerebral angiography is reported. 30 other cases from literature of the last 35 years are reviewed. The majority of aneurysms ruptured during angiography was located at the internal carotid artery. 21 out of 30 patients were females. Fatal...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
doi:
更新日期:1988-10-01 00:00:00
abstract::In spite of the availability of the new endovascular technique (GDC) to manage cerebral aneurysms, to date, the crucial question "which is the proper treatment in a given patient?" still remains unsettled. In order to check whether an answer is possible, we retrospectively reviewed a personal series of 192 consecutive...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Recent clinical trials demonstrated the efficacy of thrombectomy for ischemic stroke against acute large vessel occlusion (LVO). To overcome the problem with excessive examination time for diagnosis of cerebral perfusion and/or the use of contrast agent to determine penumbra, we adopted a new magnetic resona...
journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:10.23736/S0390-5616.18.04607-6
更新日期:2018-11-21 00:00:00