Surgical management and outcomes of petroclival meningiomas: a single-center case series of 259 patients
Surgical management and outcomes of petroclival meningiomas: a single-center case series of 259 patients
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DOI：
10.1007/s00701-013-1795-9
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发表时间：
2013-08-01
影响因子：
2.4
通讯作者：
Zhang, Jun-Ting
中科院分区：
文献类型：
--
作者：
Li, Da;Hao, Shu-Yu;Zhang, Jun-Ting
岩斜区脑膜瘤的手术治疗具有挑战性。各种和不一致的结果和预后因素的病变已被评估。本研究通过对259例岩斜区脑膜瘤患者（男70例，女189例）的手术治疗，详细介绍了岩斜区脑膜瘤的手术治疗效果、原则和经验。审查了临床图表和X线片。随访结果显示，术前Karnofsky行为量表（KPS）评分为74.2 ± 10.5。平均肿瘤大小为4.3 ± 1.0 cm。大体全切除率为52.5%。在平均55.3个月的随访期内，11例患者发生复发/进展（R/P）。近期KPS评分为78.4 ± 22.7，139例（57.2%）患者改善，53例（21.8%）患者稳定，201例（82.7%）患者独立生活。影响KPS评分的危险因素包括（但不限于）年龄a千分之一yenaEuro千分之60、术前KPS a千分之一货币符号euro千分之60和脑干水肿。影响无R/P生存率的不良因素包括（但不限于）非全切除和蛛网膜下腔缺失。5年无R/P生存率为94.5%，9年为91.2%。5年和9年的总生存率分别为94.7%和94.7%。显微手术治疗岩斜区脑膜瘤可获得良好的疗效。优先考虑神经功能和生活质量，并尝试GTR。在手术方案中应考虑危险因素，并应积极监测和治疗肿瘤复发。
Surgical management of petroclival meningiomas is challenging. Various and inconsistent outcome and prognostic factors of the lesions have been evaluated previously. In the present study, the surgical outcome, philosophy, and experience of petroclival meningiomas are detailed based on a large patient series.A series of 259 patients with petroclival meningiomas (70 males and 189 females) were surgically treated. Clinical charts and radiographs were reviewed. Follow-up results were evaluated.The preoperative Karnofsky Performance Scale (KPS) score was 74.2 +/- 10.5. The mean tumor size was 4.3 +/- 1.0 cm. The gross total resection (GTR) rate was 52.5 %. During a mean follow-up period of 55.3 months, recurrence/progression (R/P) occurred in 11 patients. The recent KPS score was 78.4 +/- 22.7, it improved in 139 (57.2 %) patients and stabilized in 53 (21.8 %) patients, and 201 (82.7 %) patients lived independently. The risk factors affecting the KPS score included (but were not limited to) age a parts per thousand yenaEuro parts per thousand 60, preoperative KPS a parts per thousand currency signaEuro parts per thousand 60, and brainstem edema. The adverse factors contributing to R/P-free survival included (but were not limited to) non-total resection and the absence of the subarachnoid space. The R/P-free survival rate was 94.5 % at 5 years and 91.2 % at 9 years. The overall survival rate was 94.7 % at 5 years and 94.7 % at 9 years.Favorable outcomes from petroclival meningiomas could be achieved by microsurgery. Neurological function and quality of life were prioritized, and GTR was attempted. Risk factors should be considered in surgical schemes, and tumor recurrence should be aggressively monitored and treated.