Risk Factors for Progression in Vestibular Schwannomas After Incomplete Resection: A Single Center Retrospective Study.
Risk Factors for Progression in Vestibular Schwannomas After Incomplete Resection: A Single Center Retrospective Study.
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不完全切除后前庭神经鞘瘤进展的危险因素：单中心回顾性研究
DOI：
10.3389/fneur.2021.778590
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发表时间：
2021
影响因子：
3.4
通讯作者：
Hui X
中科院分区：
文献类型：
--
作者：
Li J;Deng X;Ke D;Cheng J;Zhang S;Hui X
背景和目的：前庭神经鞘瘤（VS）不完全切除（IR）后进展的危险因素仍有待阐明。本研究的目的是研究术后残余VS进展的风险因素。研究方法：回顾性分析了2009年1月至2018年1月期间在我院经枕下乙状窦后入路行VS IR的140例连续患者。在随访期间，如果检测到进展，则将患者分类为进展组（PG）;如果残留肿瘤稳定或缩小，则将患者分类为稳定组（SG）。采用单因素和多因素分析方法，对影响血管硬化患者IR后病情进展的危险因素进行分析。结果如下：平均随访80.4个月（范围：24-134个月）后，35例（25.0%）患者（PG）出现进展，105例（75.0%）患者（SG）未检测到进展。PG和SG的平均肿瘤大小分别为36.5 ± 8.9 mm和31.0 ± 9.8 mm。残留肿瘤体积PG为304.6 ± 443.3 mm 3，SG为75.9 ± 60.0 mm 3。单因素分析显示，术前肿瘤大小，残留肿瘤体积，和不规则的内听道（IAC）的扩张在两组之间有显着差异，而性别，年龄，囊性成分，或Ki-67标记指数（LI）在两组之间没有显着差异。多因素分析显示残留肿瘤体积是进展的独立危险因素。结论：术前体积较大、残留肿瘤体积较大或IAC扩张不规则的接受IR的VS可能有较高的进展率。对这些患者进行严格的随访，间隔时间更短，以发现早期进展是必要的。
Background and Purpose: The risk factors for progression in vestibular schwannomas (VSs) after incomplete resection (IR) remain to be elucidated. The purpose of this study was to investigate the risk factors for progression in remnant VSs after surgery. Methods: From January 2009 to January 2018, 140 consecutive patients who underwent IR of VSs via suboccipital retrosigmoid approach in our institution were retrospectively analyzed. During follow-up, if progression was detected, the patient was classified into Progressive Group (PG); if the residual tumor was stable or shrank, the patient was classified into Stable Group (SG). Univariate analysis and multivariate analysis were used to evaluate the risk factors for progression after IR of VSs. Results: After a mean follow-up of 80.4 months (range, 24–134 months), 35 (25.0%) patients (PG) had a progression, and no progression was detected in 105 (75.0%) patients (SG). The average tumor size was 36.5 ± 8.9 mm in PG and 31.0 ± 9.8 mm in SG, respectively. The residual tumor volume was 304.6 ± 443.3 mm3 in PG and 75.9 ± 60.0 mm3 in SG, respectively. Univariate analysis showed that preoperative tumor size, residual tumor volume, and irregular internal auditory canal (IAC) expansion were significantly different between the two groups, whereas gender, age, cystic component, or Ki-67 labeling index (LI) did not differ significantly between the two groups. Multivariate analysis showed residual tumor volume was the independent risk factor for progression. Conclusions: VSs that underwent IR with larger preoperative size, greater residual tumor volume, or irregular IAC expansion may have a higher progression rate. Strict follow-up with shorter interval in these patients to detect early progression is necessary.
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影响因子：
4.8
作者：
Breshears, Jonathan D.;Morshed, Ramin A.;Theodosopoulos, Philip, V
通讯作者：
Theodosopoulos, Philip, V
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作者：
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通讯作者：
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