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Titolo:
Second surgery for recurrent pilocytic astrocytoma in children
Autore:
Bowers, DC; Krause, TP; Aronson, LJ; Barzi, A; Burger, PC; Carson, BS; Weingart, JD; Wharam, MD; Melhem, ER; Cohen, KJ;
Indirizzi:
Johns Hopkins Univ, Sch Med, Johns Hopkins Oncol Ctr, Baltimore, MD 21205 USA Johns Hopkins Univ Baltimore MD USA 21205 ol Ctr, Baltimore, MD 21205 USA Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21205 USA Johns Hopkins Univ Baltimore MD USA 21205 Pediat, Baltimore, MD 21205 USA Johns Hopkins Univ, Sch Med, Dept Radiol, Baltimore, MD 21205 USA Johns Hopkins Univ Baltimore MD USA 21205 Radiol, Baltimore, MD 21205 USA Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD 21205 USA Johns Hopkins Univ Baltimore MD USA 21205 Pathol, Baltimore, MD 21205 USA Johns Hopkins Univ, Sch Med, Dept Neurosurg, Baltimore, MD 21205 USA JohnsHopkins Univ Baltimore MD USA 21205 rosurg, Baltimore, MD 21205 USA
Titolo Testata:
PEDIATRIC NEUROSURGERY
fascicolo: 5, volume: 34, anno: 2001,
pagine: 229 - 234
SICI:
1016-2291(200105)34:5<229:SSFRPA>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOW-GRADE GLIOMAS; SPINAL-CORD TUMORS; CEREBRAL HEMISPHERES; BRAIN-TUMORS; PHASE-II; CONSERVATIVE SURGERY; RADIOTHERAPY; CARBOPLATIN; VINCRISTINE; MANAGEMENT;
Keywords:
astrocytoma, pilocytic; glioma, low grade; recurrence;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
40
Recensione:
Indirizzi per estratti:
Indirizzo: Cohen, KJ CMSC-800,600 N Wolfe St, Baltimore, MD 21287 USA CMSC-800,600 NWolfe St Baltimore MD USA 21287 re, MD 21287 USA
Citazione:
D.C. Bowers et al., "Second surgery for recurrent pilocytic astrocytoma in children", PED NEUROS, 34(5), 2001, pp. 229-234

Abstract

Pilocytic astrocytoma (PA) is the most common childhood brain tumor. In cases where the tumor progresses or recurs following primary surgical resection, the appropriate treatment is unclear. Options include chemotherapy, radiation therapy, surgical resection or a combination thereof. To analyze theutility of further surgery, we performed a retrospective, single-institution review of pediatric patients with recurrent PAs from 1990 to 1999 who were treated with a second surgical resection. Patients were excluded if theyreceived adjuvant chemotherapy or radiation therapy. Twenty cases were identified. Tumor locations included: cerebral hemisphere (3), cerebellum (7),optic pathway/hypothalamus (5), thalamus (1) and brainstem (4). The indication for 4 surgeries included an enlarging tumor-associated cyst. At secondsurgery, 10 of 20 patients had a gross total resection (GTR), 2 a near total resection (NTR), and the remaining 8 patients had a subtotal resection (STR). No patients have died, Two of 10 tumors after GTR, 0 of 2 tumors after NTR, and 7 of 8 tumors after STR had second recurrence/ progression at a mean of 15 months (range 4-33 months) following second surgery. The remaining 11 patients are recurrence/progression-free at a mean of 40.7 months (range 19-119 months). Surgery for tumors or midline structures rarely resulted in a GTR (1 of 10 cases). Surgery for tumors located in the cerebral hemispheres or cerebellum resulted in GTR or NTR in all cases and can result inlong periods of progression-free survival without further adjuvant treatment. Copyright (C) 2001 S. Karger AG, Basel.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 21:53:07