Abstract:
BACKGROUND:Before the advent of radiosurgery, neurosurgical treatment of meningiomas typically involved gross total resection of the mass whenever surgery was deemed possible. Over the past 4 decades, though, Gamma Knife radiosurgery (GKRS) has proved to be an effective, minimally invasive means to control the growth of these tumors. However, the variables associated with treatment failure (regrowth or clinical progression) after GKRS and GKRS-related complications, such as cerebral edema, are less well understood. METHODS:We retrospectively collected data between 2009 and 2018 for patients who underwent GKRS for meningiomas. After data collection, we performed univariate and multivariable modeling of the factors that predict treatment failure and cerebral edema after GKRS. Hazard ratios (HR) and P values were determined for these variables. RESULTS:Fifty-two patients were included our analysis. The majority of patients were female (38/52,73%), and nearly all patients presented with a suspected or confirmed World Health Organization grade 1 meningioma (48/52, 92%). The median tumor volume was 3.49 cc (range, 0.22-20.11 cc). Evidence of meningioma progression after treatment developed in 5 patients (10%), with a median time to continued tumor growth of 5.9 months (range, 2.7-18.3 months). In multivariable analysis, patients in whom treatment failed were more likely to be male (HR = 8.42, P = 0.045) and to present with larger tumor volumes (HR = 1.27, P = 0.011). In addition, 5 patients (10%) experienced treatment-related cerebral edema. On univariate analysis, patients who experienced cerebral edema were more likely present with larger tumors (HR = 1.16, P = 0.028). CONCLUSIONS:Increasing meningioma size and male gender predispose to meningioma progression after treatment with GKRS. Increasing tumor size also predicts the development of postradiosurgery cerebral edema.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
O'Connor KP,Algan O,Vesely SK,Palejwala AH,Briggs RG,Conner AK,Cornwell BO,Andrews B,Sughrue ME,Glenn CAdoi
10.1016/j.wneu.2019.06.152subject
Has Abstractpub_date
2019-10-01 00:00:00pages
e558-e565eissn
1878-8750issn
1878-8769pii
S1878-8750(19)31801-7journal_volume
130pub_type
杂志文章abstract:BACKGROUND:The foramen of Luschka is a natural aperture between the fourth ventricle and the subarachnoid space at the cerebellopontine angle. Membranous closure of this foramen is referred to as primary obstruction. Available information about this variant and its role in the development of the cysts of the posterior ...
journal_title:World neurosurgery
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journal_title:World neurosurgery
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abstract:BACKGROUND:For a long time, a combined transcranial and transfacial approach was the gold standard in the aspect of surgical management of large tumors with sinonasal and skull base involvement. The extended endoscopic endonasal approach for such pathologies has its advantages, but flaws as well, such as anatomical lim...
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doi:10.1016/j.wneu.2019.12.100
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2020.12.159
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doi:10.1016/j.wneu.2018.03.053
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abstract:BACKGROUND:Multiple biopsy samples are warranted for the histomolecular diagnosis of diffuse gliomas in the current molecular era, which possibly increases morbidity. OBJECTIVE:We assessed diagnostic yield, safety, and risk factors of postoperative morbidity after robot-assisted serial stereotactic biopsy sampling alo...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.127
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abstract:BACKGROUND:Oncotic aneurysm is a rare condition with a high mortality rate. Because no consensus has been reached regarding therapeutic strategy for ruptured oncotic aneurysm, treatment remains challenging. CASE DESCRIPTION:A 35-year-old woman developed sudden onset of severe headache. Computed tomography showed subar...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.049
更新日期:2018-05-01 00:00:00
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journal_title:World neurosurgery
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更新日期:2020-07-01 00:00:00
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journal_title:World neurosurgery
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journal_title:World neurosurgery
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更新日期:2019-08-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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更新日期:2020-10-01 00:00:00
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doi:10.1016/j.wneu.2020.02.172
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2016.10.060
更新日期:2017-02-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2020-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.003
更新日期:2017-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.wneu.2016.03.046
更新日期:2016-07-01 00:00:00
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doi:10.1016/j.wneu.2020.12.128
更新日期:2021-01-04 00:00:00
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2019.09.065
更新日期:2020-01-01 00:00:00
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2018.12.203
更新日期:2019-01-17 00:00:00
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pub_type: 杂志文章
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更新日期:2016-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.wneu.2018.05.025
更新日期:2018-08-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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更新日期:2016-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.265
更新日期:2019-07-01 00:00:00
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journal_title:World neurosurgery
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更新日期:2020-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2018-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.wneu.2017.03.007
更新日期:2017-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2015.11.095
更新日期:2016-03-01 00:00:00