Abstract:
OBJECTIVE:To assess the prognostic profile, clinical outcome, treatment-associated morbidity, and treatment burden of elderly patients with glioblastoma (GBM) undergoing microsurgical tumor resection as part of contemporary treatment algorithms. METHODS:We retrospectively identified patients with GBM ≥65 years of age who were treated by resection at 2 neuro-oncology centers. Survival was assessed by Kaplan-Meier analyses; log-rank tests identified prognostic factors. RESULTS:The study population included 160 patients (mean age, 73.1 ± 5.1 years), and the median contrast-enhancing tumor volume was 31.0 cm3. Biomarker analyses revealed O(6)-methylguanine-DNA methyltransferase-promoter methylation in 62.7% and wild-type isocitrate dehydrogenase in 97.5% of tumors. The median extent of resection (EOR) was 92.3%, surgical complications were noted in 10.0% of patients, and the median postoperative hospitalization period was 8 days. Most patients (60.0%) received adjuvant radio-/chemotherapy. The overall treatment-associated morbidity was 30.6%. The median progression-free and overall survival were 5.4 months (95% confidence interval [CI], 4.6-6.4 months) and 10.0 months (95% CI, 7.9-11.7 months). The strongest predictors for favorable outcome were patient age ≤73.0 years (P = 0.0083), preoperative Karnofsky Performance Status Scale score ≥80% (P = 0.0179), postoperative modified Rankin Scale score ≤1 (P < 0.0001), adjuvant treatment (P < 0.0001), and no treatment-associated morbidity (P = 0.0478). Increased EOR did not correlate with survival (P = 0.5046), but correlated significantly with treatment-associated morbidity (P = 0.0031). CONCLUSIONS:Clinical outcome for elderly patients with GBM remains limited. Nonetheless, the observed treatment-associated morbidity and treatment burden were moderate in the patients, and patient age and performance status remained the strongest predictors for survival. The risks and benefits of tumor resection in the age of biomarker-adjusted treatment concepts require further prospective evaluation.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Schwartz C,Romagna A,Stefanits H,Zimmermann G,Ladisich B,Geiger P,Rechberger J,Winkler S,Weiss L,Fastner G,Trinka E,Weis S,Spiegl-Kreinecker S,Steinbacher J,McCoy M,Johannes T,Gruber A,Rezai Jahromi B,Niemelä M,Winkdoi
10.1016/j.wneu.2019.09.097subject
Has Abstractpub_date
2020-01-01 00:00:00pages
e583-e591eissn
1878-8750issn
1878-8769pii
S1878-8750(19)32528-8journal_volume
133pub_type
杂志文章,多中心研究abstract:OBJECTIVE:Two main types of embolic protection devices have been used during carotid artery stenting (CAS): distal protection devices (DPDs) and proximal protection devices (PPDs). We compared the complications, clinical outcomes, and new ischemic lesions on diffusion-weighted magnetic resonance imaging (DWI) studies b...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.12.121
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:Vasospasm developing after subarachnoid hemorrhage (SAH) is an important cause of mortality and morbidity. Lutein is a carotenoid with antioxidant and anti-inflammatory properties. The aim of present study was to investigate effects of lutein on the basilar artery and nerve tissues. METHODS:Wistar rats were ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.186
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:Recurrent chronic subdural hematoma (CSDH) is not rare. Some studies have demonstrated the role of dexamethasone in the medical management of chronic subdural hematoma. However, no systematic study in the treatment of recurrent CSDH has been published. The aim of our study is to evaluate the efficacy and safe...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.135
更新日期:2017-09-01 00:00:00
abstract::An overview of the development of neuroendoscopy at the neurosurgery department, Ibn Sina Hospital in Kuwait, is presented with an outline of difficulties and obstacles faced by the field until it reached its current status. The factors and solutions that helped us overcome these problems are also elaborated on. After...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.05.023
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Posterior fossa arachnoid cysts are often asymptomatic, but can rarely cause postural headache, the mechanism of which remains unknown. CASE DESCRIPTION:We present a 40-year-old woman with an asymptomatic supracerebellar arachnoid cyst. Upright computed tomography (CT) showed enlargement of the arachnoid cy...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.09.132
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Chronic subdural hematoma (cSDH) is an increasingly common condition due to the growing use of anticoagulation. Currently, there remains a lack of evidence to guide the optimal timing of anticoagulant reinitiation for stroke prevention in atrial fibrillation after cSDH evacuation. We aimed to better understa...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.12.080
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Severe complications after reperfusion therapy for acute major vessel occlusion are not well described. We present an extremely rare case of a patient with rapid malignant brain swelling subacutely after acute ischemic stroke. CASE DESCRIPTION:An 84-year-old man underwent reperfusion therapy for acute left ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.07.151
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Battery replacement or revision surgery for neuromodulation implants is conventionally performed using sharp dissection. Meticulous dissection within thick scar tissue is vital to avoid damage to surrounding lead(s), which could result in more extensive revision surgery. Traditional electrosurgery devices ar...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2018.01.007
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Fusiform aneurysms are challenging lesions to manage given their poorly understood natural history and lack of a distinct neck. Historically, they have been treated surgically but endovascular management has recently evolved as a viable alternative. In this case, we describe a novel flow diversion technique ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.245
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Endoscopic surgery for lumbar stenosis is gaining acceptance because of the minimal muscle damage, short recovery times, reduced blood loss, and good clinical results. We report a novel technique of decompressing contralateral traversing and exiting nerve roots through a single interlaminar window, avoiding ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.05.111
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Infection and skin fistula are well-known complications after cranioplasty leading to reconstruction exposure and usually requiring new surgical procedure with poor condition for cutaneous closure. We describe 2 cases using muscle forehead flap (MFF) to treat skin fistula and cranioplasty exposure. CASE DES...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.10.184
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Intracranial pseudoaneurysm is a rare complication of endoscopic endonasal surgery. Herein, we describe 2-staged stent-assisted coil embolization for posterior communicating artery pseudoaneurysm after endoscopic endonasal surgery for pituitary adenoma. CASE DESCRIPTION:A 68-year-old man had a history of se...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.12.047
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:The most commonly performed nerve transfers in upper trunk (UT) or partial brachial plexus injuries (BPIs) include the spinal accessory nerve to suprascapular nerve, Oberlin, and, lately, radial nerve (RN) (branch to triceps) to axillary nerve (AN) transfers. Routinely, the former 3 procedures are performed ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.139
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Arteries that anastomose with the posterior inferior cerebellar artery (PICA) can harbor aneurysms. CASE DESCRIPTION:We present a case of a patient who suffered a subarachnoid hemorrhage as a result from an aneurysm on the left lateral spinal artery (LSA) that anastomosed to the PICA. The aneurysm was treat...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.085
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:High-field intraoperative magnetic resonance imaging (ioMRI) is becoming increasingly available in neurosurgery centers, where it has to be combined with intraoperative neurophysiologic monitoring (IONM). IONM needle electrodes remain on the patient during ioMRI and may cause image distortions ...
journal_title:World neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.wneu.2016.05.097
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:Venous thromboembolism (VTE), which includes deep venous thrombosis and pulmonary embolism, is a serious and potentially fatal surgical complication. The goal of our study was to examine preoperative characteristics, incidence, and outcomes of patients with VTE after elective thoracic/thoracolumbar level spin...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.12.089
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:Although previous reports suggest that surgery can improve the pain and disability of cervical spinal deformity (CSD), techniques are not standardized. Our objective was to assess for consensus on recommended surgical plans for CSD treatment. METHODS:Eighteen CSD cases were assembled, including a clinical vi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.04.020
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Intracranial hemorrhage is a common complication of traumatic brain injury (TBI). The purpose of this study is evaluation of the effect of tranexamic acid (TXA) on hemorrhagic mass growth in TBI patients. PATIENTS AND METHODS:In this randomized, double-blind clinical trial, 149 patients with TBI and any kin...
journal_title:World neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.wneu.2017.10.075
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to reveal inhibitory effect of gamma knife irradiation on angiogenesis of meningiomas using rat corneal angiogenesis assay. METHODS:A total of 72 rats were divided into three preliminary groups. Each group, consisting of 24 rats, was implanted to World Health Organization (WHO) grade...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2013.06.021
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:The true incidence of perioperative coronavirus disease 2019 (COVID-19) has not been well elucidated in neurosurgical studies. We reviewed the effects of the pandemic on the neurosurgical case volume to study the incidence of COVID-19 in patients undergoing these procedures during the perioperative period and...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.08.015
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:To date, no randomized trial has directly addressed the question of whether intravenous (IV) tissue plasminogen activator (tPA) improves outcomes in IV tPA-eligible patients who will eventually undergo endovascular therapy (EVT), or whether a direct EVT strategy is equally effective. We performed a systemati...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2017.08.040
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:We sought to assess whether controlled, intraoperative lumbar drainage (LD) of cerebrospinal fluid (CSF) could facilitate resection of pituitary macroadenomas and reduce the rate of CSF leak. METHODS:A retrospective cohort study from a prospective database was conducted on 189 patients with pituitary macroad...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.12.100
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To prospectively evaluate the diagnostic value of 3.0 Tesla magnetic resonance 3-dimensional sampling perfection with application-optimized contrast using different flip angle evolution (3D-SPACE) in the detection of sinus wall invasion and sinus patency in parasinus meningiomas. METHODS:In this study, 28 p...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.07.223
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:To report a series of patients with aneurysmal subarachnoid hemorrhage (SAH) and associated intracranial hematoma (ICH) who underwent coiling of the aneurysm followed immediately by open surgical decompression with evacuation of the hematoma. METHODS:With the hypothesis that aneurysm coiling before hematoma ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.06.051
更新日期:2010-12-01 00:00:00
abstract:PURPOSE:Cervical stenosis with myelopathy caused by ossification of the ligamentum flavum is relatively rare, and surgical treatment is the preferred option. Previous surgical procedures usually require assisted internal fixation, while some problems may occur, such as large trauma, intraoperative bleeding, wound infec...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.12.180
更新日期:2019-01-12 00:00:00
abstract::A 49-year-old woman presented with sudden-onset headache and meningismus. Computed tomography scan revealed a posterior fossa subarachnoid hemorrhage extending from the foramen magnum to the ambient cistern. Angiography showed a pial extramedullary arteriovenous malformation (AVM) at the lateral ventral surface of the...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.04.197
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Schwannomas not related to cranial nerves are very rare. Here, we present a case of a schwannoma that originated from the falx cerebri and review reported cases in the literature. CASE DESCRIPTION:A 36-year-old male experienced generalized seizures following right hemiparesis predominantly in his lower extr...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.12.122
更新日期:2019-01-03 00:00:00
abstract:OBJECTIVE:As a result of the resolution of intravoxel fiber crossing, high-resolution fiber tractography (HRFT) provides advantages over conventional diffusion tensor imaging (DTI) for fiber tractography (FT). Nevertheless, neurosurgically applied FT is still predominantly based on DTI. Although the application of HRFT...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.10.138
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:Obesity has become a worldwide epidemic, with very few long-term successful treatment options for refractory disease. Deep brain stimulation (DBS) of the bilateral lateral hypothalamus (LH) in refractory obesity has been performed safely. However, questions remain regarding the optimal settings and its effect...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.10.002
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Traumatic aneurysms of the superficial temporal artery have been frequently reported in the literature, whereas traumatic aneurysms of the occipital artery (OA) are extremely rare. CASE DESCRIPTION:A 30-year-old man had been followed at another hospital for meningoencephalocele associated with his congenita...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.09.116
更新日期:2017-01-01 00:00:00