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首页> 外文期刊>British journal of neurosurgery >Extent of resection predicts risk of progression in adult pilocytic astrocytoma
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Extent of resection predicts risk of progression in adult pilocytic astrocytoma

机译：切除程度预测成人紫胶鸡星形细胞瘤的进展风险

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Object: Pilocytic astrocytomas are rare tumours in adults. Presentation, management and prognostic factors are poorly characterised. Methods: Retrospective single centre study from 2000 to 2016. Results: 50 cases were identified (median age 29 years; range 16-76). Symptoms at presentation were neurological deficit (n = 21), headache (n = 18) and seizures (n = 6). Five were incidental findings. Five patients had hydrocephalus at presentation and required emergent management, two by endoscopic third ventriculostomy and three by external ventricular drain. Symptoms were present for a median of 16 weeks (range 1 week to 34 years). Surgery consisted of gross total resection (n = 23), subtotal resection (n = 21) or biopsy (n = 6). Progression occurred in 20 patients at a median time of 7 years following surgery and was asymptomatic in just over half of these cases. A greater degree of resection (complete vs. subtotal) was associated with longer time to progression (Kaplan-Meier analysis, log rank test = 3.58, p = 0.059). At their first progression 12 patients underwent re-resective surgery and the remainder received radiotherapy. The median 5-year survival was 80%. Conclusions: In adult patients with a pilocytic astrocytoma, a macroscopic resection should be the aim at the first resective operation. Emergency management of hydrocephalus may be required in the first instance.
机译：对象：紫氏霉素星形细胞瘤是成年人中罕见的肿瘤。介绍，管理和预后因素的特征不佳。方法：从2000年到2016年回顾性单中心研究。结果：确定了50例（中位年龄29岁; 16-76级）。呈现的症状是神经缺陷（n = 21），头痛（n = 18）和癫痫发作（n = 6）。五是偶然的调查结果。五名患者在介绍和所需的芽孢杆菌患者中患有脑积水，两种通过内窥镜第三脑膜术和三个由外部心室排放。症状为16周的中位数（范围为1周至34岁）。手术由总切除总体（n = 23），小次切除（n = 21）或活组织检查（n = 6）组成。在手术后7年的中位时间发生在20名患者中发生进展，在这些情况下超过一半是无症状的。更大程度的切除（完整的与小计）与较长的进展时间相关联（Kaplan-Meier分析，日志等级测试= 3.58，P = 0.059）。在他们的第一个进展中，12名患者接受了重新接触手术和剩余的接受放疗。中位5年生存率为80％。结论：在成年患者中患有紫叶胶质细胞瘤，宏观切除术应瞄准第一次参与手术。在第一个案例中可能需要脑积水的应急管理。

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