Thalamic Glioblastoma: Clinical Presentation, Management Strategies, and Outcomes
| العنوان: | Thalamic Glioblastoma: Clinical Presentation, Management Strategies, and Outcomes |
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| المؤلفون: | Cameron Brennan, Thomas W. Link, Natalie DiStefano, Viviane Tabar, Philip H. Gutin, Yoshua Esquenazi, Koos E. Hovinga, Nelson Moussazadeh, Anne S. Reiner |
| المصدر: | Neurosurgery |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Oncology, medicine.medical_specialty, Multivariate analysis, Stereotactic biopsy, Adolescent, medicine.medical_treatment, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Correspondence, Humans, Medicine, Young adult, Craniotomy, Aged, Proportional Hazards Models, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, Brain Neoplasms, business.industry, Proportional hazards model, Incidence (epidemiology), Retrospective cohort study, Research-Human-Clinical Studies, Middle Aged, medicine.disease, Hydrocephalus, Treatment Outcome, 030220 oncology & carcinogenesis, Female, Surgery, Neurology (clinical), Glioblastoma, business, 030217 neurology & neurosurgery |
| الوصف: | Background Thalamic glioblastomas (GBMs) represent a significant neurosurgical challenge. In view of the low incidence of these tumors, outcome data and management strategies are not well defined. Objective To identify the natural history and factors associated with survival in patients with thalamic glioblastoma. Methods A retrospective review of all patients with thalamic glioblastoma over a 10-yr period was performed. Presenting clinical, radiological, and outcome data were collected. Chi-squared and Fisher's exact tests were used to compare clinical characteristics across tumor groups. Cox proportional hazard models were utilized to investigate variables of interest with regard to overall survival. Results Fifty-seven patients met inclusion criteria, with a median age of 53 and median Karnofsky Performance Scale (KPS) score of 80. The most common presenting symptoms were weakness, confusion, and headache. Hydrocephalus was present in 47% of patients preoperatively. Stereotactic biopsy was performed in 47 cases, and 10 patients underwent craniotomy. The median overall survival was 12.2 mo. Higher KPS, younger age, and cerebrospinal fluid (CSF) diversion were correlated with better overall survival univariately, respectively, while the presence of language deficits at initial presentation was associated with poorer survival. In multivariate analysis, the only significant predictor of survival was presenting KPS. Conclusion The overall survival of patients with thalamic glioblastoma is comparable to unresectable lobar supratentorial GBMs. Younger patients and those with good presenting functional status had improved survival. Midbrain involvement by the tumor is not a negative prognostic factor. Improved therapies are needed, and patients should be considered for early trial involvement and aggressive upfront therapy. |
| تدمد: | 1524-4040 0148-396X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7d59289b598d1784436a548e8e267f4eTest https://doi.org/10.1093/neuros/nyx349Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....7d59289b598d1784436a548e8e267f4e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244040 0148396X |
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