Ventricular entry during surgical resection is associated with intracranial leptomeningeal dissemination in glioblastoma patients.
Ventricular entry during surgical resection is associated with intracranial leptomeningeal dissemination in glioblastoma patients.
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DOI：
10.1007/s11060-022-04166-6
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发表时间：
2022-11
影响因子：
3.9
通讯作者：
Della Puppa, Alessandro
中科院分区：
文献类型：
--
作者：
Battista, Francesca;Muscas, Giovanni;Dinoi, Francesca;Gadda, Davide;Della Puppa, Alessandro
胶质母细胞瘤(GBM)与发生软脑膜播散(LMD)时预后较差有关。最近，手术中的脑室进入(VE)和肿瘤的脑室下区定位在促进GBM患者LMD方面的作用一直存在争议。本文旨在探讨VE在GBM患者LMD发生中的作用。我们对2018年3月至2020年12月期间在我所施行的GBM进行了回顾性分析。我们收集了手术前和手术后的图像、记忆信息和手术报告。收集了200个案例。基底膜位于脑室周围者占69.5%，术中有VE者占51%。VE患者术后发生LMD的风险为16%。VE组LMD发生率高于非VE组(27.4%vs.4%，p <； 0.0001)。脑室周围基底膜LMD的发生率为19%(p = 0.1131)。根据我们的数据，VE是手术后LMD发生率较高的独立因素，而脑室周围的位置与这一负面结果没有独立的相关性。神经外科医生应尽可能避免VE。正确的手术策略应该建立在平衡最大EOR的需要和VE相关风险的基础上。
Glioblastoma (GBM) is associated with a poorer prognosis when leptomeningeal dissemination (LMD) occurs. Recently, the role of both ventricular entry (VE) during surgery and subventricular zone localization of tumors in promoting LMD in GBM patients has been debated. This article investigates the role of VE in causing LMD in GBM patients. We conducted a retrospective analysis of GBMs operated on at our Institution between March 2018 and December 2020. We collected pre- and post-surgical images, anamnestic information, and surgical reports. Two hundred cases were collected. The GBM localization was periventricular in 69.5% of cases, and there was a VE during the surgical procedure in 51% of cases. The risk of post-surgical LMD in the case of VE was 16%. The rate of LMD was higher in the case of VE than not-VE (27.4% vs. 4%, p < 0.0001). The rate of LMD in periventricular GBM was 19% (p = 0.1131). According to our data, VE is an independent factor associated with a higher rate of post-surgical LMD, and the periventricular localization is not independently correlated to this negative outcome. Neurosurgeons should avoid VE when possible. The correct surgical strategy should be founded on balancing the need for maximal EOR and the risks associated with VE.
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