Your browser doesn't support javascript.
loading
Post-operative cardiovascular complications and time to recurrence in meningioma patients treated with versus without pre-operative embolization: a retrospective cohort study of 741 patients.
Wirsching, Hans-Georg; Richter, Johannes Konstantin; Sahm, Felix; Morel, Corinne; Krayenbuehl, Niklaus; Rushing, Elisabeth Jane; von Deimling, Andreas; Valavanis, Antonios; Weller, Michael.
Afiliación
  • Wirsching HG; Department of Neurology, University Hospital and University of Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland. hans-georg.wirsching@usz.ch.
  • Richter JK; Department of Neuroradiology, University Hospital and University of Zurich, Zurich, Switzerland.
  • Sahm F; Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital and University of Bern, Bern, Switzerland.
  • Morel C; Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.
  • Krayenbuehl N; Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Rushing EJ; Department of Neurology, University Hospital and University of Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland.
  • von Deimling A; Department of Neurosurgery, University Hospital and University of Zurich, Zurich, Switzerland.
  • Valavanis A; Department of Neuropathology, University Hospital and University of Zurich, Zurich, Switzerland.
  • Weller M; Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.
J Neurooncol ; 140(3): 659-667, 2018 Dec.
Article en En | MEDLINE | ID: mdl-30196368
PURPOSE: Preoperative embolization of radiographically suspected meningiomas is often performed to facilitate tumor resection. Its effects on the subsequent disease course of meningioma patients have not been studied in detail and randomized trials are lacking. The purpose of this study was to explore associations of preoperative meningioma embolization with postoperative outcome. PATIENTS AND METHODS: Patients undergoing resection of an intracranial meningioma at the University Hospital Zurich 2000-2013 (N = 741) were reviewed for the inclusion of pre-operative embolization in the management strategy. Annotations included demographics, radiographic, surgical, histological and hematological parameters, cardiovascular risk factors, pre- and postoperative neurological function and gene methylation-based classification. Binary regression and Cox proportional hazards models were applied to determine factors associated with outcome. RESULTS: Pre-operative embolization was performed in 337 patients (42%). Cardiovascular events after surgery comprised mostly deep vein thrombosis (N = 39) and pulmonary embolisms (N = 64). On multivariate analyses of post-operative cardiovascular adverse events controlling for established risk factors, there were associations with embolization (OR 2.38, 95% CI 1.37-4.00), and with female gender (OR 2.18, 95% CI 1.17-4.08). Recurrence-free survival (RFS) of embolized patients was less favorable among patients with WHO grade II or grade III meningiomas (median RFS: 4.3 vs. 7.0 years, P = 0.029) or in patients with intermediate or malignant gene methylation subtype meningiomas (median RFS: 2.0 vs. 8.2 years, P = 0.005). CONCLUSION: Pre-operative meningioma embolization may cause adverse outcomes. Randomized trials to determine benefit-risk ratios are warranted to clarify the role of pre-operative embolization for the treatment of meningioma patients.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Preoperatorios / Enfermedades Cardiovasculares / Embolización Terapéutica / Neoplasias Meníngeas / Meningioma / Recurrencia Local de Neoplasia Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Año: 2018 Tipo del documento: Article País de afiliación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Preoperatorios / Enfermedades Cardiovasculares / Embolización Terapéutica / Neoplasias Meníngeas / Meningioma / Recurrencia Local de Neoplasia Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Año: 2018 Tipo del documento: Article País de afiliación: Suiza
...