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  • 1
    Language: English
    In: Cerebrovascular diseases (Basel, Switzerland), 2013-03, Vol.35 (2), p.93-112
    Description: Background: Intracranial aneurysm with and without subarachnoid haemorrhage (SAH) is a relevant health problem: The overall incidence is about 9 per 100,000 with a wide range, in some countries up to 20 per 100,000. Mortality rate with conservative treatment within the first months is 50–60%. About one third of patients left with an untreated aneurysm will die from recurrent bleeding within 6 months after recovering from the first bleeding. The prognosis is further influenced by vasospasm, hydrocephalus, delayed ischaemic deficit and other complications. The aim of these guidelines is to provide comprehensive recommendations on the management of SAH with and without aneurysm as well as on unruptured intracranial aneurysm. Methods: We performed an extensive literature search from 1960 to 2011 using Medline and Embase. Members of the writing group met in person and by teleconferences to discuss recommendations. Search results were graded according to the criteria of the European Federation of Neurological Societies. Members of the Guidelines Committee of the European Stroke Organization reviewed the guidelines. Results: These guidelines provide evidence-based information on epidemiology, risk factors and prognosis of SAH and recommendations on diagnostic and therapeutic methods of both ruptured and unruptured intracranial aneurysms. Several risk factors of aneurysm growth and rupture have been identified. We provide recommendations on diagnostic work up, monitoring and general management (blood pressure, blood glucose, temperature, thromboprophylaxis, antiepileptic treatment, use of steroids). Specific therapeutic interventions consider timing of procedures, clipping and coiling. Complications such as hydrocephalus, vasospasm and delayed ischaemic deficit were covered. We also thought to add recommendations on SAH without aneurysm and on unruptured aneurysms. Conclusion: Ruptured intracranial aneurysm with a high rate of subsequent complications is a serious disease needing prompt treatment in centres having high quality of experience of treatment for these patients. These guidelines provide practical, evidence-based advice for the management of patients with intracranial aneurysm with or without rupture. Applying these measures can improve the prognosis of SAH.
    Subject(s): Guidelines ; Predictive Value of Tests ; Prognosis ; Aneurysm, Ruptured - mortality ; Risk Assessment ; Aneurysm, Ruptured - diagnosis ; Subarachnoid Hemorrhage - therapy ; Humans ; Risk Factors ; Intracranial Aneurysm - mortality ; Intracranial Aneurysm - diagnosis ; Evidence-Based Medicine ; Consensus ; Incidence ; Intracranial Aneurysm - therapy ; Aneurysm, Ruptured - therapy ; Subarachnoid Hemorrhage - mortality ; Subarachnoid Hemorrhage - diagnosis ; Index Medicus
    ISSN: 1015-9770
    E-ISSN: 1421-9786
    Source: Karger Journals Archiv (DFG Nationallizenzen)
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 2
    Language: English
    In: Acta neuropathologica, 2015-01, Vol.129 (1), p.133-146
    Description: Diffuse gliomas are represented in the 2007 WHO classification as astrocytomas, oligoastrocytomas and oligodendrogliomas of grades II and III and glioblastomas WHO grade IV. Molecular data on these tumors have a major impact on prognosis and therapy of the patients. Consequently, the inclusion of molecular parameters in the WHO definition of brain tumors is being planned and has been forwarded as the “ISN-Haarlem” consensus. We, here, analyze markers of special interest including ATRX, IDH and 1p/19q codeletion in a series of 405 adult patients. Among the WHO 2007 classified tumors were 152 astrocytomas, 61 oligodendrogliomas, 63 oligoastrocytomas and 129 glioblastomas. Following the concepts of the “ISN-Haarlem”, we rediagnosed the series to obtain “integrated” diagnoses with 155 tumors being astrocytomas, 100 oligodendrogliomas and 150 glioblastomas. In a subset of 100 diffuse gliomas from the NOA-04 trial with long-term follow-up data available, the “integrated” diagnosis had a significantly greater prognostic power for overall and progression-free survival compared to WHO 2007. Based on the “integrated” diagnoses, loss of ATRX expression was close to being mutually exclusive to 1p/19q codeletion, with only 2 of 167 ATRX-negative tumors exhibiting 1p/19q codeletion. All but 4 of 141 patients with loss of ATRX expression and diffuse glioma carried either IDH1 or IDH2 mutations. Interestingly, the majority of glioblastoma patients with loss of ATRX expression but no IDH mutations exhibited an H3F3A mutation. Further, all patients with 1p/19 codeletion carried a mutation in IDH1 or IDH2. We present an algorithm based on stepwise analysis with initial immunohistochemistry for ATRX and IDH1-R132H followed by 1p/19q analysis followed by IDH sequencing which reduces the number of molecular analyses and which has a far better association with patient outcome than WHO 2007.
    Subject(s): Pathology ; Neurosciences ; Medicine & Public Health ; 1p/19q ; 7p/10q ; ATRX ; Glioblastoma ; H3F3A ; IDH ; Diffuse glioma ; Astrocytoma ; Oligodendroglioma ; Prognosis ; Oligodendroglioma - genetics ; Humans ; Middle Aged ; Oligodendroglioma - diagnosis ; Brain Neoplasms - pathology ; Male ; X-linked Nuclear Protein ; Brain Neoplasms - metabolism ; DNA Copy Number Variations ; Young Adult ; Astrocytoma - pathology ; Glioblastoma - genetics ; Oligodendroglioma - metabolism ; Aged, 80 and over ; Adult ; Female ; Glioblastoma - metabolism ; Nuclear Proteins - genetics ; Astrocytoma - diagnosis ; DNA Helicases - genetics ; Astrocytoma - genetics ; Astrocytoma - metabolism ; Glioblastoma - diagnosis ; Brain Neoplasms - diagnosis ; Brain Neoplasms - genetics ; Isocitrate Dehydrogenase - genetics ; Nuclear Proteins - metabolism ; Immunohistochemistry - methods ; DNA Helicases - metabolism ; Algorithms ; Oligodendroglioma - pathology ; Glioblastoma - pathology ; Adolescent ; Isocitrate Dehydrogenase - metabolism ; Aged ; Mutation ; Immunohistochemistry ; Glioblastoma multiforme ; Index Medicus
    ISSN: 0001-6322
    E-ISSN: 1432-0533
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 3
    Language: English
    In: The New England journal of medicine, 2014-03-20, Vol.370 (12), p.1091-1100
    Description: In patients older than 60 years of age with extensive middle-cerebral-artery strokes, early hemicraniectomy improved survival as compared with treatment in the ICU alone. The majority of survivors had substantial disability and required assistance with most bodily needs. Large space-occupying middle-cerebral-artery or hemispheric ischemic brain infarcts are associated with the development of massive brain edema, which may lead to herniation and early death. This condition, which has been described as malignant middle-cerebral-artery infarction, is associated with 80% mortality due to herniation during the first week, despite maximal conservative treatment in the intensive care unit (ICU), including osmotherapy, barbiturates, and hyperventilation. 1 – 8 Conservative therapies for ischemic brain edema are not supported by sufficient evidence from clinical trials. 9 , 10 Decompressive hemicraniectomy (temporary removal of a large part of the skull) combined with duraplasty allows edematous tissue to expand outside the . . .
    Subject(s): Neurology ; Biological and medical sciences ; General aspects ; Vascular diseases and vascular malformations of the nervous system ; Medical sciences ; Intensive Care Units ; Prospective Studies ; Humans ; Middle Aged ; Male ; Survival Rate ; Infarction, Middle Cerebral Artery - therapy ; Infarction, Middle Cerebral Artery - mortality ; Infarction, Middle Cerebral Artery - complications ; Aged, 80 and over ; Craniotomy - methods ; Infarction, Middle Cerebral Artery - surgery ; Female ; Aged ; Disabled Persons ; Anencephaly ; Stroke (Disease) ; Treatment outcome ; Usage ; Care and treatment ; Analysis ; Aged patients ; Risk factors ; Cerebral infarction ; Stroke ; Older people ; Mortality ; Surgery ; Clinical trials ; Brain surgery ; Survival ; Patients ; Veins & arteries ; Index Medicus ; Abridged Index Medicus
    ISSN: 0028-4793
    E-ISSN: 1533-4406
    Source: Single Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 4
    Language: English
    In: Acta neuropathologica, 2015, Vol.129 (6), p.867-873
    Description: The WHO 2007 classification of tumors of the CNS distinguishes between diffuse astrocytoma WHO grade II (A IIWHO2007) and anaplastic astrocytoma WHO grade III (AA III WHO2007). Patients with A II WHO2007 are significantly younger and survive significantly longer than those with AA III WHO2007. So far, classification and grading relies on morphological grounds only and does not yet take into account IDH status, a molecular marker of prognostic relevance. We here demonstrate that WHO 2007 grading performs poorly in predicting prognosis when applied to astrocytoma carrying IDH mutations. Three independent series including a total of 1360 adult diffuse astrocytic gliomas with IDH mutation containing 683 A II IDHmut, 562 AA III IDHmut and 115 GBM IDHmut have been examined for age distribution and survival. In all three series patients with A II IDHmut and AA III IDHmut were of identical age at presentation of disease (36-37 years) and the difference in survival between grades was much less (10.9 years for A II IDHmut, 9.3 years for AA III IDHmut) than that reported for A II WHO2007 versus AA III WHO2007. Our analyses imply that the differences in age and survival between A II WHO2007 and AA III WHO2007 predominantly depend on the fraction of IDH-non-mutant astrocytomas in the cohort. This data poses a substantial challenge for the current practice of astrocytoma grading and risk stratification and is likely to have far-reaching consequences on the management of patients with IDH-mutant astrocytoma.
    Subject(s): Astrocytoma - genetics ; Age Distribution ; World Health Organization ; Humans ; Middle Aged ; Brain Neoplasms - genetics ; Isocitrate Dehydrogenase - genetics ; Male ; Mutation - genetics ; Young Adult ; Chromosomes, Human, Pair 1 ; Brain Neoplasms - classification ; Adolescent ; Survival Analysis ; Adult ; Female ; Astrocytoma - classification ; Brain Neoplasms - mortality ; Astrocytoma - mortality ; Astrocytoma ; Index Medicus
    ISSN: 0001-6322
    E-ISSN: 1432-0533
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 5
    Language: English
    In: Acta neuropathologica, 2009, Vol.118 (4), p.469-474
    Description: Somatic mutations in the IDH1 gene encoding cytosolic NADP+-dependent isocitrate dehydrogenase have been shown in the majority of astrocytomas, oligodendrogliomas and oligoastrocytomas of WHO grades II and III. IDH2 encoding mitochondrial NADP+-dependent isocitrate dehydrogenase is also mutated in these tumors, albeit at much lower frequencies. Preliminary data suggest an importance of IDH1 mutation for prognosis showing that patients with anaplastic astrocytomas, oligodendrogliomas and oligoastrocytomas harboring IDH1 mutations seem to fare much better than patients without this mutation in their tumors. To determine mutation types and their frequencies, we examined 1,010 diffuse gliomas. We detected 716 IDH1 mutations and 31 IDH2 mutations. We found 165 IDH1 (72.7%) and 2 IDH2 mutations (0.9%) in 227 diffuse astrocytomas WHO grade II, 146 IDH1 (64.0%) and 2 IDH2 mutations (0.9%) in 228 anaplastic astrocytomas WHO grade III, 105 IDH1 (82.0%) and 6 IDH2 mutations (4.7%) in 128 oligodendrogliomas WHO grade II, 121 IDH1 (69.5%) and 9 IDH2 mutations (5.2%) in 174 anaplastic oligodendrogliomas WHO grade III, 62 IDH1 (81.6%) and 1 IDH2 mutations (1.3%) in 76 oligoastrocytomas WHO grade II and 117 IDH1 (66.1%) and 11 IDH2 mutations (6.2%) in 177 anaplastic oligoastrocytomas WHO grade III. We report on an inverse association of IDH1 and IDH2 mutations in these gliomas and a non-random distribution of the mutation types within the tumor entities. IDH1 mutations of the R132C type are strongly associated with astrocytoma, while IDH2 mutations predominantly occur in oligodendroglial tumors. In addition, patients with anaplastic glioma harboring IDH1 mutations were on average 6 years younger than those without these alterations.
    Subject(s): Brain Neoplasms - enzymology ; Glioma - enzymology ; Prognosis ; Age Factors ; Humans ; Middle Aged ; Brain Neoplasms - pathology ; Brain Neoplasms - genetics ; Isocitrate Dehydrogenase - genetics ; Male ; Glioma - genetics ; DNA Mutational Analysis ; Glioma - pathology ; Brain - pathology ; Adult ; Female ; Cell Differentiation ; Mutation ; Tumor Cells, Cultured ; Index Medicus
    ISSN: 0001-6322
    E-ISSN: 1432-0533
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 6
    Language: English
    In: Clinical cancer research, 2008-01-01, Vol.14 (1), p.123-129
    Description: Purpose: The CD133 antigen has been identified as a putative stem cell marker in normal and malignant brain tissues. In gliomas, it is used to enrich a subpopulation of highly tumorigenic cancer cells. According to the cancer stem cell hypothesis, CD133-positive cells determine long-term tumor growth and, therefore, are suspected to influence clinical outcome. To date, a correlation between CD133 expression in primary tumor tissues and patients' prognosis has not been reported. Experimental Design: To address this question, we analyzed the expression of the CD133 stem cell antigen in a series of 95 gliomas of various grade and histology by immunohistochemistry on cryostat sections. Staining data were correlated with patient outcome. Results: By multivariate survival analysis, we found that both the proportion of CD133-positive cells and their topological organization in clusters were significant ( P 〈 0.001) prognostic factors for adverse progression-free survival and overall survival independent of tumor grade, extent of resection, or patient age. Furthermore, proportion of CD133-positive cells was an independent risk factor for tumor regrowth and time to malignant progression in WHO grade 2 and 3 tumors. Conclusions: These findings constitute the first conclusive evidence that CD133 stem cell antigen expression correlates with patient survival in gliomas, lending support to the current cancer stem cell hypothesis.
    Subject(s): stem cells ; glioma ; prognosis ; CD133 ; Neurology ; Biological and medical sciences ; Medical sciences ; Tumors of the nervous system. Phacomatoses ; Antineoplastic agents ; Pharmacology. Drug treatments ; Immunohistochemistry ; Glioma - mortality ; Prognosis ; Peptides ; Antigens, CD - biosynthesis ; Humans ; Middle Aged ; Brain Neoplasms - pathology ; Kaplan-Meier Estimate ; Male ; Stem Cells - metabolism ; AC133 Antigen ; Brain Neoplasms - metabolism ; Glioma - metabolism ; Glycoproteins - biosynthesis ; Disease-Free Survival ; Glioma - pathology ; Survival Analysis ; Adult ; Female ; Brain Neoplasms - mortality ; Index Medicus
    ISSN: 1078-0432
    E-ISSN: 1557-3265
    Source: HighWire Press (Free Journals)
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 7
    Language: English
    In: Acta neuropathologica, 2015-09, Vol.130 (3), p.407-417
    Description: IDH wild type (IDHwt) anaplastic astrocytomas WHO grade III (AA III) are associated with poor outcome. To address the possibilities of molecular subsets among astrocytoma or of diagnostic reclassification, we analyzed a series of 160 adult IDHwt tumors comprising 120 AA III and 40 diffuse astrocytomas WHO grade II (A II) for molecular hallmark alterations and established methylation and copy number profiles. Based on molecular profiles and hallmark alterations the tumors could be grouped into four major sets. 124/160 (78 %) tumors were diagnosed as the molecular equivalent of conventional glioblastoma (GBM), and 15/160 (9 %) as GBM-H3F3A mutated (GBM-H3). 13/160 (8 %) exhibited a distinct methylation profile that was most similar to GBM-H3-K27, however, lacked the H3F3A mutation. This group was enriched for tumors of infratentorial and midline localization and showed a trend towards a more favorable prognosis. All but one of the 120 IDHwt AA III could be assigned to these three groups. 7 tumors recruited from the 40 A II, comprised a variety of molecular signatures and all but one were reclassified into distinct WHO entities of lower grades. Interestingly, TERT mutations were exclusively restricted to the molecular GBM (78 %) and associated with poor clinical outcome. However, the GBM-H3 group lacking TERT mutations appeared to fare even worse. Our data demonstrate that most of the tumors diagnosed as IDHwt astrocytomas can be allocated to other tumor entities on a molecular basis. The diagnosis of IDHwt diffuse astrocytoma or anaplastic astrocytoma should be used with caution.
    Subject(s): Pathology ; Neurosciences ; Medicine & Public Health ; TERT ; IDH1 ; IDH2 ; Glioblastoma ; Classification ; H3F3A ; Astrocytoma ; Astrocytoma - genetics ; Astrocytoma - metabolism ; Immunohistochemistry ; Promoter Regions, Genetic ; Humans ; Middle Aged ; Brain Neoplasms - pathology ; Brain Neoplasms - genetics ; Isocitrate Dehydrogenase - genetics ; Biomarkers, Tumor ; Brain Neoplasms - metabolism ; Astrocytoma - pathology ; DNA Methylation ; Neoplasm Grading ; Telomerase - genetics ; Glioblastoma - genetics ; Brain Neoplasms - classification ; Glioblastoma - pathology ; Survival Analysis ; Glioblastoma - classification ; Glioblastoma - metabolism ; Astrocytoma - classification ; Mutation ; Cohort Studies ; Methylation ; Telomerase ; Analysis ; Tumors ; Index Medicus
    ISSN: 0001-6322
    E-ISSN: 1432-0533
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 8
    Language: English
    In: Molecular therapy, 2017-12-06, Vol.25 (12), p.2620-2634
    Description: Oncolytic virotherapy may be a means of improving the dismal prognosis of malignant brain tumors. The rat H-1 parvovirus (H-1PV) suppresses tumors in preclinical glioma models, through both direct oncolysis and stimulation of anticancer immune responses. This was the basis of ParvOryx01, the first phase I/IIa clinical trial of an oncolytic parvovirus in recurrent glioblastoma patients. H-1PV (escalating dose) was administered via intratumoral or intravenous injection. Tumors were resected 9 days after treatment, and virus was re-administered around the resection cavity. Primary endpoints were safety and tolerability, virus distribution, and maximum tolerated dose (MTD). Progression-free and overall survival and levels of viral and immunological markers in the tumor and peripheral blood were also investigated. H-1PV treatment was safe and well tolerated, and no MTD was reached. The virus could cross the blood-brain/tumor barrier and spread widely through the tumor. It showed favorable pharmacokinetics, induced antibody formation in a dose-dependent manner, and triggered specific T cell responses. Markers of virus replication, microglia/macrophage activation, and cytotoxic T cell infiltration were detected in infected tumors, suggesting that H-1PV may trigger an immunogenic stimulus. Median survival was extended in comparison with recent meta-analyses. Altogether, ParvOryx01 results provide an impetus for further H-1PV clinical development. Through an early-phase clinical trial in recurrent glioblastoma patients, Geletneky et al. show that the oncolytic H-1 parvovirus is safe, well tolerated, and able to establish an immunogenic tumor microenvironment. Blood-brain/tumor crossing and favorable survival compared with historical controls make this virus an interesting candidate for further clinical development.
    Subject(s): clinical trial ; oncolytic parvovirus ; glioblastoma ; tumor microenvironment ; Animal models ; Intravenous administration ; Laboratories ; Brain tumors ; Brain cancer ; Glioblastoma ; Cytotoxicity ; Viruses ; Lymphocytes T ; Macrophages ; Metastases ; Proteins ; Cell activation ; Immunotherapy ; Peripheral blood ; DNA methylation ; Oncolysis ; Deoxyribonucleic acid--DNA ; Consciousness ; Radiation therapy ; Metabolism ; Patients ; Microglia ; Glioma ; Immunogenicity ; Pharmacokinetics ; Index Medicus ; Original
    ISSN: 1525-0016
    E-ISSN: 1525-0024
    Source: PubMed Central
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 9
    Language: English
    In: Acta neuropathologica, 2016-06, Vol.131 (6), p.903-910
    Description: With the number of prognostic and predictive genetic markers in neuro-oncology steadily growing, the need for comprehensive molecular analysis of neuropathology samples has vastly increased. We therefore developed a customized enrichment/hybrid-capture-based next-generation sequencing (NGS) gene panel comprising the entire coding and selected intronic and promoter regions of 130 genes recurrently altered in brain tumors, allowing for the detection of single nucleotide variations, fusions, and copy number aberrations. Optimization of probe design, library generation and sequencing conditions on 150 samples resulted in a 5-workday routine workflow from the formalin-fixed paraffin-embedded sample to neuropathological report. This protocol was applied to 79 retrospective cases with established molecular aberrations for validation and 71 prospective cases for discovery of potential therapeutic targets. Concordance of NGS compared to established, single biomarker methods was 98.0 %, with discrepancies resulting from one case where a TERT promoter mutation was not called by NGS and three ATRX mutations not being detected by Sanger sequencing. Importantly, in samples with low tumor cell content, NGS was able to identify mutant alleles that were not detectable by traditional methods. Information derived from NGS data identified potential targets for experimental therapy in 37/47 (79 %) glioblastomas, 9/10 (90 %) pilocytic astrocytomas, and 5/14 (36 %) medulloblastomas in the prospective target discovery cohort. In conclusion, we present the settings for high-throughput, adaptive next-generation sequencing in routine neuropathology diagnostics. Such an approach will likely become highly valuable in the near future for treatment decision making, as more therapeutic targets emerge and genetic information enters the classification of brain tumors.
    Subject(s): Medicine & Public Health ; Pathology ; Neurosciences ; Molecular Probe Techniques ; Brain Neoplasms - diagnosis ; Humans ; Brain Neoplasms - genetics ; Pathology, Molecular - methods ; High-Throughput Nucleotide Sequencing - methods ; Mutation - genetics ; Genetic markers ; Gliomas ; Analysis ; Brain tumors ; Formaldehyde ; Index Medicus
    ISSN: 0001-6322
    E-ISSN: 1432-0533
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 10
    Language: English
    In: Clinical & experimental metastasis, 2020-04, Vol.37 (2), p.377-390
    Description: Metastatic spinal cord compression (MSCC) is a frequent phenomenon in advanced tumor diseases with often severe neurological impairments. Affected patients are often treated by decompressive laminectomy. To assess the impact of this procedure on Karnofsky Performance Index (KPI) and Frankel Grade (FG) at discharge, a single center retrospective cohort study of neurologically impaired MSCC-patients treated with decompressive laminectomy between 2004 and 2014 was performed. 101 patients (27 female/74 male; age 66.1 ± 11.5 years) were identified. Prostate was the most common primary tumor site (40%) and progressive disease was present in 74%. At admission, 80% of patients were non-ambulatory (FG A-C). Imaging revealed prevalently thoracic MSCC (78%). Emergency surgery (〈 24 h) was performed in 71% and rates of complications and revision surgery were 6% and 4%, respectively. At discharge, FG had improved in 61% of cases, and 51% of patients had regained ambulation. Univariate predictors for not regaining the ability to walk were bowl dysfunction (p = 0.0015), KPI 〈 50% (p = 0.048) and FG 〈 C (p = 0.001) prior to surgery. In conclusion, decompressive laminectomy showed beneficial effects on the functional outcome at discharge. A good neurological status prior to surgery was key predictor for a good functional outcome.
    Subject(s): Index Medicus ; Decompressive surgery ; Frankel grade ; Ambulation ; Metastatic spinal cord compression (MSCC) ; Research Paper ; Laminectomy ; Spinal metastases
    ISSN: 0262-0898
    E-ISSN: 1573-7276
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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