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Uporedna analiza kliničko-radiološke prezentacije, histološkog nalaza i operativnog ishoda tumora moždanog stabla

Comparative analysis of clinical and radiological presentation, histological findings and operative outcome of brainstem tumors

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Author
Repac, Nikola
Mentor
Tasić, Goran
Committee members
Đurović, Branko
Rasulić, Lukas
Pavlović, Dragan
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Abstract
Gliomi moždanog stabla čine manje od 2% tumora mozga odraslih. Terapeutske opcije su limitirane i one su udružene sa visokom stopom morbiditeta i mortaliteta. Materijal i metod. Prikazujemo seriju od 51 pacijenta hospitalizovanog u Klinici za neurohirurgiju Kliničkog centra Srbije u periodu od 1998 do 2012 godine. Beležili smo demografske i kliničke varijable, kao i histopatološki nalaz i klinički ishod. Rezultati. Od 51 pacijenta 62,7% su bila muškog pola, a 37,3% ženskog pola, prosečne starosti 30,6±19,3 godina. U uzrastu 38.2±17.9 godina dominira visokogradusni tip glioma (As. gr. III i IV) – t=2.481, p=0.017. Dok histološki tip As. gr. I-II dominantan u mlađem uzrastu 25.4±17.4 godina - X2=4.013; p=0.045, sa lokalizacijom u ponsu - X2=5.299; p=0.021 i prisutnom egzofitičnom komponentom - X2=3.862; p=0.049. Ataksija kao inicijalni simptom je prediktor lošeg ishoda - HR 5.546; p=0.012. Zaključak. Zbog specifične lokalizacije gliomi moždanog stabla (GMS) zbog svoje lokalizacije i dana...s predstavljaju veliki izazov za neurohiruge, zbog potrebe identifikacije bezbednog pristupa i mogućnosti što radikalnije resekcije. Histološka verifikacija GMS određuje potrebu za dodatnim terapijskim procedurama – zračenje i hemioterapija. Benefit od korektne dijagnoze ogleda se u izbegavanju potencijalno neželjenih terapijskih efekata.

Brain stem gliomas constitute less than 2% of brain tumors in adults. Therapeutic options are limited and brainstem gliomas are associated with a high morbidity and mortality. Materials and methods. We reviewed the records of 51 patients with brainstem gliomas treated at the Institute of Neurosurgery, Clinical Center of Serbia in Belgrade between 1998 and 2012. We recorded demographic and clinical variables as well as radiological findings and survival. Results. Of the 51 patients 62.7% were male and 37.3% female, mean age 30.6 ± 19.3 years. At the age 38.2 ± 17.9 years dominated the high grade type of glioma (As. Gr. III and IV) - t = 2.481, p = 0.017. While histological type As. gr. I-II dominant in the younger age 25.4 ± 17.4 years - X2 = 4.013; p = 0.045, with localization in the pons - X2 = 5.299; p = 0.021 and present exophytic component - X2 = 3.862; p = 0.049. Ataxia as initial symptom is a predictor of poor outcome - HR 5.546; p = 0.012. Conclusion. Due to its specific localiz...ation brain stem gliomas (BSG) today present a major challenge for neurosurgery, because of need for safe approach due to radical resection. Histological verification BSG determines the need for additional therapeutic procedures - radiation and chemotherapy. Benefit from correct diagnosis is reflected in the avoidance of potentially adverse effects of treatment.

Faculty:
University of Belgrade, School of Medicine
Date:
19-07-2016
Keywords:
Gliomi moždanog stabla / Adults / brainstem gliomas / histology / survival / odrasli / histologija / preživljavanje
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URI
http://eteze.bg.ac.rs/application/showtheses?thesesId=4297
http://nardus.mpn.gov.rs/handle/123456789/7318
https://fedorabg.bg.ac.rs/fedora/get/o:14082/bdef:Content/download
https://fedorabg.bg.ac.rs/fedora/get/o:14242/bdef:Izvestaj/download
http://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=48483087

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