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The role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients
BACKGROUND: The aim of this study was to evaluate the effect of surgical resection and stereotactic biopsy on the complication rate, progression-free survival (PFS) and overall survival (OS) of 70 patients diagnosed at a single institution with primary central nervous system lymphoma (PCNSL) and to...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8112018/ https://www.ncbi.nlm.nih.gov/pubmed/33975554 http://dx.doi.org/10.1186/s12883-021-02227-3 |
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author | Wu, Shiqiang Wang, Junwen Liu, Weihua Hu, Feng Zhao, Kai Jiang, Wei Lei, Ting Shu, Kai |
author_facet | Wu, Shiqiang Wang, Junwen Liu, Weihua Hu, Feng Zhao, Kai Jiang, Wei Lei, Ting Shu, Kai |
author_sort | Wu, Shiqiang |
collection | PubMed |
description | BACKGROUND: The aim of this study was to evaluate the effect of surgical resection and stereotactic biopsy on the complication rate, progression-free survival (PFS) and overall survival (OS) of 70 patients diagnosed at a single institution with primary central nervous system lymphoma (PCNSL) and to explore the predictors of selection for resection and the prognostic factors of PCNSL. METHODS: A retrospective analysis was performed of 70 patients with PCNSL that was diagnosed by surgical resection or stereotactic brain biopsy in our department from January 2013 to May 2019. We divided the patients into two groups: a resection group (n = 28) and a stereotactic biopsy group (n = 42). Data on clinical characteristics, imaging findings, complication rates, PFS and OS were retrospectively reviewed and compared between these two groups. We also analysed the predictors of selection for resection and prognostic factors of PCNSL by multivariate analysis. RESULTS: The median age was 53.3 ± 14.3 years, and there was a male predominance with a sex ratio of 1.33:1. The most common clinical manifestation was a headache. The complication rate in the resection group was 10.7% versus 7.1% in the stereotactic biopsy group, and there was no statistically significant difference. The rate of improvement in symptoms of the resection group was significantly higher than that of the stereotactic biopsy group. Multivariable analysis identified a single tumour and not involving deep structures as predictors of selection for resection. With a median follow-up of 30 months (range 1–110), the mean OS and PFS of all patients were 16.1 months and 6.2 months, respectively. Patients who underwent surgical resection had a mean OS of 23.4 months and PFS of 8.6 months versus 11.2 months and 4.6 months for those who had a brain biopsy performed. In addition, multivariable analysis showed that not involving deep structures and resection were favourable prognostic factors for PCNSL. CONCLUSIONS: The outcomes of patients with PCNSL treated in our cohort are still poor. In our series, surgical resection might play a role in significantly improving OS and PFS compared with stereotactic biopsy in a subset of patients. The type of surgery and tumour location are prognostic factors for PCNSL. |
format | Online Article Text |
id | pubmed-8112018 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-81120182021-05-11 The role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients Wu, Shiqiang Wang, Junwen Liu, Weihua Hu, Feng Zhao, Kai Jiang, Wei Lei, Ting Shu, Kai BMC Neurol Research Article BACKGROUND: The aim of this study was to evaluate the effect of surgical resection and stereotactic biopsy on the complication rate, progression-free survival (PFS) and overall survival (OS) of 70 patients diagnosed at a single institution with primary central nervous system lymphoma (PCNSL) and to explore the predictors of selection for resection and the prognostic factors of PCNSL. METHODS: A retrospective analysis was performed of 70 patients with PCNSL that was diagnosed by surgical resection or stereotactic brain biopsy in our department from January 2013 to May 2019. We divided the patients into two groups: a resection group (n = 28) and a stereotactic biopsy group (n = 42). Data on clinical characteristics, imaging findings, complication rates, PFS and OS were retrospectively reviewed and compared between these two groups. We also analysed the predictors of selection for resection and prognostic factors of PCNSL by multivariate analysis. RESULTS: The median age was 53.3 ± 14.3 years, and there was a male predominance with a sex ratio of 1.33:1. The most common clinical manifestation was a headache. The complication rate in the resection group was 10.7% versus 7.1% in the stereotactic biopsy group, and there was no statistically significant difference. The rate of improvement in symptoms of the resection group was significantly higher than that of the stereotactic biopsy group. Multivariable analysis identified a single tumour and not involving deep structures as predictors of selection for resection. With a median follow-up of 30 months (range 1–110), the mean OS and PFS of all patients were 16.1 months and 6.2 months, respectively. Patients who underwent surgical resection had a mean OS of 23.4 months and PFS of 8.6 months versus 11.2 months and 4.6 months for those who had a brain biopsy performed. In addition, multivariable analysis showed that not involving deep structures and resection were favourable prognostic factors for PCNSL. CONCLUSIONS: The outcomes of patients with PCNSL treated in our cohort are still poor. In our series, surgical resection might play a role in significantly improving OS and PFS compared with stereotactic biopsy in a subset of patients. The type of surgery and tumour location are prognostic factors for PCNSL. BioMed Central 2021-05-11 /pmc/articles/PMC8112018/ /pubmed/33975554 http://dx.doi.org/10.1186/s12883-021-02227-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Wu, Shiqiang Wang, Junwen Liu, Weihua Hu, Feng Zhao, Kai Jiang, Wei Lei, Ting Shu, Kai The role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients |
title | The role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients |
title_full | The role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients |
title_fullStr | The role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients |
title_full_unstemmed | The role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients |
title_short | The role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients |
title_sort | role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8112018/ https://www.ncbi.nlm.nih.gov/pubmed/33975554 http://dx.doi.org/10.1186/s12883-021-02227-3 |
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