Relative survival of patients with non-malignant central nervous system tumours: a descriptive study by the Austrian Brain Tumour Registry.

BACKGROUND: Unlike malignant primary central nervous system (CNS) tumours outcome data on non-malignant CNS tumours are scarce. For patients diagnosed from 1996 to 2002 5-year relative survival of only 85.0% has been reported. We investigated this rate in a contemporary patient cohort to update information on survival. METHODS: We followed a cohort of 3983 cases within the Austrian Brain Tumour Registry. All patients were newly diagnosed from 2005 to 2010 with a histologically confirmed non-malignant CNS tumour. Vital status, cause of death, and population life tables were obtained by 31 December 2011 to calculate relative survival. RESULTS: Overall 5-year relative survival was 96.1% (95% CI 95.1-97.1%), being significantly lower in tumours of borderline (90.2%, 87.2-92.7%) than benign behaviour (97.4%, 96.3-98.3%). Benign tumour survival ranged from 86.8 for neurofibroma to 99.7% for Schwannoma; for borderline tumours survival rates varied from 83.2 for haemangiopericytoma to 98.4% for myxopapillary ependymoma. Cause of death was directly attributed to the CNS tumour in 39.6%, followed by other cancer (20.4%) and cardiovascular disease (15.8%). CONCLUSION: The overall excess mortality in patients with non-malignant CNS tumours is 5.5%, indicating a significant improvement in survival over the last decade. Still, the remaining adverse impact on survival underpins the importance of systematic registration of these tumours.

[Stereotaxic biopsy of brain tumors]. / Streotaktická biopsia mozgových nádorov.

The work re-evaluates the meaning of stereotactic bioptic examination in 50 neurosurgical patients. Bioptic material gained for histologic purposes does not secure always the achievement of the correct histologic diagnosis. The authors critically reevaluate the possibilities of this diagnostic method. They do not consider as adequate to claim multiple expansive processes to be inoperable, respectively as being refractory towards therapy, when the histologic conclusion is lacking. In cases of inconsistency in histologic conclusions from two neuropathologists the further fate of the patient is conditioned by the neuropathologist's stand-point, but also by the clinical experience of the neurosurgeon who overtakes the final responsibility for the patient's further fate. Recently available methods (CT,MR, spectrography) are diagnostically not so precise as to be able to manage without stereotactic biopsy. (Tab. 3, Fig. 5, Ref. 10.).

[Pathogenesis and therapy of nontraumatic compressive radial nerve paralyses--report of an unusual case]. / Zur Pathogenese und Therapie nicht-traumatischer kompressiver Radialislähmungen--Bericht über einen ungewöhnlichen Fall.

A case of nontraumatic radial nerve palsy at the level of the canalis spiralis is reported. Aetiologically a variation of branching of this nerve combined with an inflammatory swelling is discussed. After the surgical treatment a satisfactory recovery of motor function was seen. The necessity for a careful and thorough examination is demonstrated to diagnose or localise such non-traumatic lesions.

[EEG controls in recurrences of supratentorial brain-specific tumors]. / EEG-Verlaufskontrollen bei Rezidiven von supratentoriellen hirneigenen Tumoren.

The purpose of this study was to find out the value of postoperative EEG controls in the early detection of recurrence of supratentorial gliomas (the majority being astrocytomas, stage II to IV). 29 cases with verified tumour recurrence were examined and in all but one the EEG showed a reactivation of the focus in accordance with the development of the glioma. At least one of the following parameters had to be established: a further spreading of the focal changes, a reduction in frequency, an increase in amplitudes and focal depression of amplitudes. At least 3 postoperative EEG controls were made in each case. The duration of tumour treatment was 3 to 59 months. In 3 cases temporary focus activation was found without evidence of tumour recurrence; in one of these cases the activation was preceded by an epileptic seizure. Epileptic seizures, thus, seem to have a focus activating effect. Focus activation as a result of radiotherapy or cytostatic treatment was not observed. On the basis of our findings it appears that regularly conducted postoperative EEG controls seem to be highly suited as a non-invasive and economical method for the early detection of recurrence of this type of tumour. In the case of malignant types of gliomas involving rapid growth EEG controls should be made monthly.