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Titolo:
Limitations of stereotactic biopsy in the initial management of gliomas
Autore:
Jackson, RJ; Fuller, GN; Abi-Said, D; Lang, FF; Gokaslan, ZL; Shi, WM; Wildrick, DM; Sawaya, R;
Indirizzi:
Univ Texas, MD Anderson Canc Ctr, Dept Neurosurg, Houston, TX 77030 USA Univ Texas Houston TX USA 77030 tr, Dept Neurosurg, Houston, TX 77030 USA Univ Texas, MD Anderson Canc Ctr, Dept Pathol, Houston, TX 77030 USA Univ Texas Houston TX USA 77030 c Ctr, Dept Pathol, Houston, TX 77030 USA
Titolo Testata:
NEURO-ONCOLOGY
fascicolo: 3, volume: 3, anno: 2001,
pagine: 193 - 200
SICI:
1522-8517(200107)3:3<193:LOSBIT>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANAPLASTIC GLIOMAS; SURGICAL RESECTION; RADIATION-THERAPY; MALIGNANT GLIOMAS; BRAIN MASSES; SURVIVAL; GRADE; DIAGNOSIS; LESIONS; SURGERY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
42
Recensione:
Indirizzi per estratti:
Indirizzo: Sawaya, R Univ Texas, MD Anderson Canc Ctr, Dept Neurosurg, Box 442,1515 Holcombe Blvd, Houston, TX 77030 USA Univ Texas Box 442,1515 Holcombe Blvd Houston TX USA 77030 0 USA
Citazione:
R.J. Jackson et al., "Limitations of stereotactic biopsy in the initial management of gliomas", NEURO-ONCOL, 3(3), 2001, pp. 193-200

Abstract

Stereotactic biopsy is often performed for diagnostic purposes before treating patients whose imaging studies highly suggest glioma, Indications cited for biopsy include diagnosis and/or the "inoperability" of the tumor. This study questions the routine use of stereotactic biopsy in the initial management of gliomas, At The University of Texas M, D, Anderson Cancer Center, we retrospectively reviewed a consecutive series of 81 patients whose imaging studies suggested glioma and who underwent stereotactic biopsy followed by craniotomy/resection (within 60 days) between 1993 and 1998. All relevant clinical and imaging information was reviewed, including computerized volumetric analysis of the tumors based on pre- and postoperative MRI. Stereotactic biopsy was performed at institutions other than M, D, Anderson in 78 (96%) of 81 patients. The majority of tumors were located either in eloquent brain (36 of 81 = 44%) or near-eloquent brain (41 of 81 = 51%), and this frequently was the rationale cited for performing stereotactic biopsy. Gross total resection (> 95%) was achieved in 46 (57%) of 81 patients, with amedian extent of resection of 96% for this series. Diagnoses based on biopsy or resection in the same patient differed in 40 (49%) of 82 cases. This discrepancy was reduced to 30 (38%) of 80 cases when the biopsy slides werereviewed preoperatively by each of three neuropathologists at M, D, Anderson, Major neurologic complications occurred in 10 (12.3%) of 81 surgical patients and 3 (3.7%) of 81 patients undergoing biopsy. Surgical morbidity was probably higher in our series than it would be for glioma patients in general because our patients represent a highly selected subset of glioma patients whose tumors present a technical challenge to remove. Stereotactic biopsy is frequently inaccurate in providing a correct diagnosis and is associated with additional risk and cost. If streotactic biopsy is performed, expert neuropathology consultation should be sought.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/02/20 alle ore 22:34:21