of a nomogram could help doctors make clinical decisions and effectively follow-up patients, which would improve the prognosis. 10 Therefore, establishing a nomogram to predict the prognosis of clival chordoma could be very useful, and predicting the prognosis is critical to both neurosurgeons and patients for treatment decision-making. The aim of our study is to create and validate a nomogram to predict progression-free survival (PFS) of clival chordoma. Methods Study Population A total of 201 patients who underwent an operation using an endonasal endoscopic
Yixuan Zhai, Jiwei Bai, Mingxuan Li, Shuai Wang, Chuzhong Li, Xinting Wei and Yazhuo Zhang
Giannina L. Garcés-Ambrossi, Matthew J. McGirt, Vivek A. Mehta, Daniel M. Sciubba, Timothy F. Witham, Ali Bydon, Jean-Paul Wolinksy, George I. Jallo and Ziya L. Gokaslan
-enhanced MR images of an intramedullary high-grade astrocytoma obtained before surgery (A) and 48 hours after STR (B). Tumor progression developed in 31 patients (31%) at a median of 11 months (IQR 1–26 months) postoperatively. Progression-free survival correlated closely with tumor histology (p < 0.0001) ( Fig. 5 ). After adjusting for histology in the multivariate analysis, the presence of an identifiable tumor plane was associated with improved PFS (HR 0.44, p = 0.027) (see Fig. 8A ; Table 2 ). A GTR, compared with STR, was associated with improved PFS in cases of
Maria Wostrack, Florian Ringel, Sven O. Eicker, Max Jägersberg, Karl Schaller, Johannes Kerschbaumer, Claudius Thomé, Ehab Shiban, Michael Stoffel, Benjamin Friedrich, Victoria Kehl, Peter Vajkoczy, Bernhard Meyer and Julia Onken
predictive factors and both transient and permanent postoperative impairment (follow-up data [or discharge data for those with missing follow-up]), as well as the EOR, was analyzed using multivariate logistic regression models. The Kaplan-Meier log-rank test and multivariate Cox regression analysis were used to calculate and to compare progression-free survival (PFS). A p value < 0.05 was considered statistically significant. The odds ratio and its 95% confidence interval were specified for statistically significant parameters. Center effects were accounted for by
Brian J. Williams, Chun Po Yen, Robert M. Starke, Bhuvaneswara Basina, James Nguyen, Jessica Rainey, Jonathan H. Sherman, David Schlesinger and Jason P. Sheehan
Stereotactic radiosurgery serves as an important primary and adjuvant treatment option for patients with many types of intracranial meningiomas. This is particularly true for patients with parasellar meningiomas. In this study, the authors evaluated the outcomes of Gamma Knife surgery (GKS) used to treat parasellar meningiomas.
The study is a retrospective review of the outcomes in 138 patients with meningiomas treated at the University of Virginia from 1989 to 2006; all patients had a minimum follow-up of 24 months. There were 31 men and 107 women whose mean age was 54 years (range 19–85 years). Eighty-four patients had previously undergone resection. The mean pre-GKS tumor volume was 7.5 ml (range 0.2–54.8 ml). Clinical and radiographic evaluations were performed, and factors related to favorable outcomes in each case were assessed.
The mean follow-up duration was 84 months (median 75.5 months, range 24–216 months). In 118 patients (86%), the tumor volume was unchanged or had decreased at last follow-up. Kaplan-Meier analysis demonstrated radiographic progression-free survival at 5 and 10 years to be 95.4% and 69%, respectively. Fourteen patients (10%) developed new cranial nerve palsies following GKS. Factors associated with tumor control included younger age, a higher isodose, and smaller tumor volume. A longer follow-up duration was associated with either a decrease or increase in tumor volume. Fourteen patients (10%) experienced new or worsening cranial nerve deficits after treatment. Factors associated with this occurrence were larger pretreatment tumor volume, lower peripheral radiation dose, lower maximum dose, tumor progression, and longer follow-up.
Gamma Knife surgery offers an acceptable rate of tumor control for parasellar meningiomas and accomplishes this with a low incidence of neurological deficits. Radiological control after radiosurgery is more likely in those patients with a smaller tumor volume and a higher prescription dose.
Nicole Angela Terpolilli, Moritz Ueberschaer, Maximilian Niyazi, Christoph Hintschich, Rupert Egensperger, Alexander Muacevic, Niklas Thon, Jörg-Christian Tonn and Christian Schichor
postoperative treatment (W&W or radiation therapy within 6 months of surgery); length of follow-up (months); incidence of tumor recurrence or regrowth; localization and timing of tumor recurrence; symptoms at the time of diagnosis of tumor recurrence; progression-free survival (PFS); type of recurrence treatment; type of radiation therapy; side effects of radiation therapy; dose (Gy); and symptoms after recurrence treatment. Histopathological Classification Patient samples were classified according to the WHO classification of 2007. 27 Therefore, all patient samples obtained
Cheng-Chia Lee, Huai-Che Yang, Ching-Jen Chen, Yi-Chieh Hung, Hsiu-Mei Wu, Cheng-Ying Shiau, Wan-Yuo Guo, David Hung-Chi Pan, Wen-Yuh Chung and Kang-Du Liu
the Mantel-Haenszel test for linear association, as appropriate. Statistics of the means were determined using the unpaired Student t-test, with and without equal variance (Levene test), as necessary, and the Wilcoxon rank-sum test when the variables were not normally distributed. Kaplan-Meier curves were plotted for progression-free survival and overall survival rates from the time of GKS, last follow-up, and treatment failure, if any. The logistic regression model was used to analyze the prognostic factors of hypopituitarism. Significant variables and interaction
Jiun-Lin Yan, Anouk van der Hoorn, Timothy J. Larkin, Natalie R. Boonzaier, Tomasz Matys and Stephen J. Price
postsurgical contrast-enhanced T1-weighted image. Statistical Analysis Data were analyzed using SPSS version 22 (IBM Inc.). A Cox regression model was used to estimate the influence of the EOR based on p, q, FLAIR, and postcontrast T1-weighted images on progression-free survival and overall survival. Multivariate analysis included the following covariates: age, MGMT methylation status, IDH-1 mutation status, presurgical tumor volume based on postcontrast T1-weighted images, tumor location based on eloquence, and midline shift. These covariates were tested
Surgical management of giant presacral schwannoma: systematic review of published cases and meta-analysis
Presented at the 2019 AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves
Zach Pennington, Erick M. Westbroek, A. Karim Ahmed, Ethan Cottrill, Daniel Lubelski, Matthew L. Goodwin and Daniel M. Sciubba
–11 , 13–17 , 19 , 20 , 22 , 23 , 25 , 28–62 , 64–74 , 77 , 79–84 , 87 All 103 were included in survival analysis, with those missing postoperative follow-up data being censored at 0 months. We found no significant difference in progression-free survival (PFS) across Klimo type (p = 0.50; Fig. 3A ). There was a significant difference in PFS between tumors treated with en bloc resection and STR (p = 0.03), but not between en bloc resection and GTR (p = 0.25) or GTR and STR (p = 0.25; Fig. 3B ). Ten-year PFS was 100% for tumors treated with en bloc resection, 95% for
Julia J. Compton, Nadia N. Issa Laack, Laurence J. Eckel, David A. Schomas, Caterina Giannini and Fredric B. Meyer
outcomes by univariate analysis. These variables— age, sex, tumor size, histology, extent of resection, radiation therapy, chemotherapy, sensory motor symptoms at presentation, supratentorial location, and enhancement on CT and/or MRI—were chosen because of their documented prognostic value. Progression-free survival and overall survival curves were calculated using the Kaplan-Meier method 6 and compared with the log-rank test. 12 Deaths without documented recurrence were considered as censored observations for recurrence at time of death. All tests were 2-tailed. A p
Mostafa El Khashab, Lynn Gargan, Linda Margraf, Korgun Koral, Farideh Nejat, Dale Swift, Bradley Weprin and Daniel C. Bowers
in 18 and incomplete tumor resection in 16 patients). Four children received adjuvant therapy after surgery, including radiation therapy (3 patients) and chemotherapy (1 patient). There were no operative deaths. Progression-Free Survival and Overall Survival Seven patients have experienced tumor progression during follow-up evaluation, 1 of whom has died. The 5-year tumor PFS rate was 81.2% ( Fig. 1 ), and the overall survival for patients was 97.4%. The mean interval to tumor progression was 2.6 ± 3.6 years (range 0.11–10.01 years). F ig . 1. Graph