Extent of Resection and Overall Survival for Patients With Atypical and Malignant Meningioma
Extent of Resection and Overall Survival for Patients With Atypical and Malignant Meningioma
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DOI：
10.1002/cncr.29639
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发表时间：
2015-12-15
期刊：
影响因子：
6.2
通讯作者：
Alexander, Brian M.
中科院分区：
文献类型：
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作者：
Aizer, Ayal A.;Bi, Wenya Linda;Alexander, Brian M.
背景：非典型脑膜瘤和恶性脑膜瘤患者的预后尚不明确；在这一人群中，手术切除的程度是否与基于生存的预后相关仍不明确。本研究调查了非典型脑膜瘤和恶性脑膜瘤患者的大部全切除与全因死亡率之间的关系。方法：采用监测、流行病学和结局计划，对2004年至2009年间确诊的575例18~70岁恶性脑膜瘤患者和575例脑膜瘤患者进行分析。多变量COX比例风险回归用于评估GTR与大部切除对全因死亡率的调整后的影响。结果：接受过GTR的患者和未接受GTR的患者的基线患者特征相似。非典型脑膜瘤患者和恶性脑膜瘤患者的5年总生存率分别为91.3%(95%可信区间，86.2%~94.5%)和78.2%(95%CI，70.0%~84.3%)，恶性脑膜瘤患者分别为64.5%(95%CI，45.9%~78.1%)和41.1%(95%CI，17.9%~63.1%)。在调整了可用的、相关的混杂变量后，非典型肺炎患者的全因死亡率较低(风险比，0.39；95%可信区间，0.23-0.67；P
BACKGROUND: The prognosis for patients with atypical and malignant meningioma is guarded; whether the extent of resection is associated with survival-based outcomes in this population remains poorly defined. This study investigated the association between gross total resection (GTR) and all-cause mortality in patients with atypical and malignant meningioma. METHODS: The Surveillance, Epidemiology, and End Results program was used to identify 575 and 64 patients betweens the ages of 18 and 70 years who were diagnosed with atypical and malignant meningioma, respectively, between 2004 and 2009. Multivariate Cox proportional hazards regression was used to assess the adjusted impact of GTR versus subtotal resection on all-cause mortality. RESULTS: Baseline patient characteristics were similar for patients who did undergo GTR and patients who did not undergo GTR. The 5-year overall survival rates were 91.3% (95% confidence interval [CI], 86.2%-94.5%) and 78.2% (95% CI, 70.0%-84.3%) for patients with atypical meningioma who did and did not undergo GTR, respectively, and 64.5% (95% CI, 45.9%-78.1%) and 41.1% (95% CI, 17.9%-63.1%) for patients with malignant meningioma who did and did not undergo GTR, respectively. After adjustments for available, pertinent confounding variables, GTR was associated with lower all-cause mortality in patients with atypical (hazard ratio, 0.39; 95% CI, 0.23-0.67; P