Gross total resection improves overall survival in children with choroid plexus carcinoma.
Gross total resection improves overall survival in children with choroid plexus carcinoma.
复制标题
肉眼全切除可提高脉络丛癌儿童的总生存率。
DOI：
10.1007/s11060-013-1281-5
复制
发表时间：
2014
影响因子：
3.9
通讯作者：
Parsa,AndrewT
中科院分区：
文献类型：
--
作者：
Sun,MatthewZ;Ivan,MichaelE;Clark,AaronJ;Oh,MichaelC;Delance,ArthurR;Oh,Taemin;Safaee,Michael;Kaur,Gurvinder;Bloch,Orin;Molinaro,Annette;Gupta,Nalin;Parsa,AndrewT
脉络丛癌是一种少见的恶性原发脑肿瘤，预后较差。虽然之前的报告显示了积极手术的好处，但很少有大规模研究专门关注儿科人群，对他们来说，积极手术的风险必须仔细权衡其好处。我们对儿科CPC进行了全面系统的回顾，以测试大部全切除(GTR)对总生存期(OS)和无进展生存期(PFS)的影响。进行Pubmed搜索以确定接受手术切除的患有CPC的儿童。仅包括经CT或MRI证实切除范围的分类临床病例用于分析。采用Kaplan-Meier生存分析和多因素Cox生存分析，确定手术切除范围对OS和PFS的影响。分析了已知切除范围和总存活率的102例儿科CPC患者(年龄18岁，≤)的分类临床数据。通过Kaplan-Meier分析(LOGRAKP<；0.001)，Gtr与更好的OS显著相关。对年龄、性别、肿瘤部位(幕上与幕下)和辅助治疗类型(化疗、放疗和联合治疗)进行校正后的多变量COX回归分析显示，GRT独立增加了OS(p=0.006)。在Kaplan-Meier分析中，GTR也改善了PFS(p=0.027)，但在我们的多变量COX模型中，这种效果不符合我们的显著性标准(p=0.120)。GTR改善了儿童CPC的OS，如能安全实施则推荐使用。
Choroid plexus carcinoma (CPC) is a rare, malignant, primary brain tumor with a poor prognosis. While previous reports have shown benefits of aggressive surgery, very few large-scale studies have focused exclusively on the pediatric population, for whom the risks of aggressive surgery must be weighed carefully against the benefits. We performed a comprehensive systematic review of pediatric CPCs to test the effects of gross total resection (GTR) on overall survival (OS) and progression-free survival (PFS). A Pubmed search was performed to identify children with CPC who underwent surgical resection. Only disaggregated clinical cases in which extent of resection was confirmed by CT or MRI were included for analysis. Kaplan–Meier and multivariate Cox regression survival analyses were performed to determine the effects of extent of resection on OS and PFS. Disaggregated clinical data from a total of 102 pediatric CPC patients (age ≤18 years) with known extent of resection and overall survival were analyzed. GTR was significantly associated with better OS by Kaplan–Meier analysis (logrankp< 0.001). Multivariate Cox regression analysis adjusting for age, gender, tumor location (supratentorial vs. infratentorial), and type of adjuvant therapy (chemotherapy, radiation, and combined therapy), showed that GTR independently increased OS (p= 0.006). While GTR also improved PFS on Kaplan–Meier analysis (p= 0.027), the effect did not meet our criteria for significance in our multivariate Cox model (p= 0.120). GTR improved OS of pediatric CPC and is recommended if it can be safely performed.