摘要
目的探讨影响世界卫生组织(WHO)Ⅲ级脑膜瘤术后复发的相关因素。方法回顾性分析2011年9月至2017年10月郑州大学第一附属医院45例初次诊断为WHOⅢ级脑膜瘤患者的临床和随访资料,应用单因素Kaplan-Meier生存分析及多因素COX回归对其性别、年龄、肿瘤部位、术前KPS评分、肿瘤切除程度、是否瘤周水肿、肿瘤最大直径、是否侵犯周围结构、术后是否放疗、Ki-67指数及非恶性脑膜瘤手术史等指标进行分析。结果 45例患者随访时间为1～66个月,中位时间9个月(P25:4,P75:25),无复发生存期(RFS)为1～66个月,中位时间为7个月(P25:2.5,P75:19.5),共23例(51.1%)复发。肿瘤切除程度、肿瘤部位、术后是否放疗、是否侵犯周围结构的单因素分析结果具有统计学意义(P <0.05)。多因素COX回归发现肿瘤部位(P=0.011,RR=3.400,95%CI:1.771～12.841)及手术切除程度(P=0.002,RR=3.400,95%CI:1.332～8.683)是影响肿瘤复发的独立危险因素。结论术后是否放疗及肿瘤是否侵犯周围结构可能影响肿瘤的复发,肿瘤部位与手术切除程度是影响肿瘤复发的独立危险因素。尽可能全切肿瘤及术后辅助放疗是主要治疗方法。
Objective To explore the factors related to the postoperative recurrence of World Health Organization(WHO)grade Ⅲ meningioma.Methods There were 45 patients with WHO grade Ⅲ meningioma diagnosed in our hospital from September 2011 to October 2017 were collected. One-way Kaplan-Meier survival analysis and multivariate COX regression were used to analyze the gender,age,tumor site,preoperative KPS scale,tumor resection status,peritumoral edema,maximum tumor diameter,invasion,postoperative radiotherapy,Ki-67 index and non-malignant meningioma surgery history.Results The 45 patients were followed up for 1 to 66 months with a median of 9 months(P25:4,P75:25). The recurrence-free survival(RFS)is 1 to 66 months and the median RFS is 7 months(P25:2.5,P75:19.5). There were 23 patients who had recurrence(51.1%). Univariate analysis of tumor resection status,tumor site,postoperative radiotherapy and invasion were statistically significant(P < 0.05).In the Multivariate COX regression analysis,tumor site(P = 0.011,RR = 3.400,95%CI:1.771 ~ 12.841)and tumor resection status(P = 0.002,RR = 3.400,95%CI:1.332 ~ 8.683)were the independent factors that related to the recurrence.Conclusions Radiotherapy and tumor invasion may affect recurrence,tumor site and tumor resec-tion status,which are independent risk factors for recurrence. Resect tumor as much as possible and the postopera-tive adjuvant radiotherapy are the main treatments.
作者
李东明
孙红卫
LI Dongming;SUN Hongwei(Department of Neurosurgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第24期4110-4114,共5页
The Journal of Practical Medicine
基金
河南省自然科学基金项目(编号:162300410307)
河南省医学科技攻关计划项目(编号:201602087)
