Surgical strategies for nonenhancing slow-growing gliomas with special reference to functional reorganization: review with own experience.
Surgical strategies for nonenhancing slow-growing gliomas with special reference to functional reorganization: review with own experience.
复制标题
非增强性缓慢生长神经胶质瘤的手术策略，特别是功能重组：根据自己的经验进行回顾。
DOI：
10.2176/nmc.53.438
复制
发表时间：
2013
影响因子：
1.9
通讯作者：
J. Hamada
中科院分区：
文献类型：
--
作者：
Y. Hayashi;M. Nakada;M. Kinoshita;J. Hamada
尽管手术后一小部分肿瘤可能被诊断为世界卫生组织(WHO)III级胶质瘤，但对非增强型固有脑肿瘤的治疗经验表明，该策略已被应用于世界卫生组织(WHO)II级胶质瘤(低级别胶质瘤：LGGs)。然而，包括LGGs在内的非强化胶质瘤的最佳手术策略仍然存在争议。LGGs具有生长缓慢、恶性转化的可能性高、肿瘤与邻近正常脑组织边界不清等特点。我们回顾了2006年1月至2012年5月在金泽大学医院接受手术治疗的连续26例无强化胶质瘤患者，特别参考了清醒手术中的功能重组、切除范围(EOR)和功能定位。这些分类与LGG的特点密切相关，即由于生长缓慢而进行的功能重组，与恶变相关的EOR，以及勾画不清楚肿瘤边界的功能图谱。最后，我们讨论了以LGGs和无强化的胶质瘤为代表的生长缓慢的胶质瘤的外科治疗策略。总之，生长缓慢的胶质瘤倾向于进行功能重组，而功能重组会影响基于口才的肿瘤位置对可切除性的术前评估。在临床环境中，为了明确确定重组的功能区，建议进行清醒手术。因此，清醒手术可以增加肿瘤的切除范围而无损伤，从而延缓恶变，提高总体生存率。
Nonenhancing intrinsic brain tumors have been empirically treated with a strategy that has been adopted for World Health Organization (WHO) grade II gliomas (low-grade gliomas: LGGs), even though small parts of the tumors might have been diagnosed as WHO grade III gliomas after surgery. However, the best surgical strategy for nonenhancing gliomas, including LGGs, is still debatable. LGGs have the following features: slow growth, high possibility of histologically malignant transformation, and no clear border between the tumor and adjacent normal brain. We retrospectively examined 26 consecutive patients with nonenhancing gliomas who were surgically treated at Kanazawa University Hospital between January 2006 and May 2012, with special reference to functional reorganization, extent of resection (EOR), and functional mapping during awake surgery. These categories are closely related with the features of LGG, i.e. functional reorganization due to slow-growing nature, EOR with related malignant transformation, and functional mapping for delineating the unclear tumor border. Finally, we discuss surgical strategies for slow-growing gliomas that are represented by LGGs and nonenhancing gliomas. In conclusion, slow-growing gliomas tend to undergo functional reorganization, and the functional reorganization affects the presurgical evaluation for resectability based on tumor location related to eloquence. In the clinical setting, to definitely identify the reorganized functional regions, awake surgery is recommended. Therefore, awake surgery could increase the extent of the resection of the tumor without deficits, resulting in the delay of malignant transformation and increase in overall survival.
功能标测引导的低级别胶质瘤切除术。
DOI：
--
发表时间：
1995
期刊：
Clinical neurosurgery.
影响因子：
--
作者：
Berger,MS
通讯作者：
Berger,MS