Long-Term Outcomes of Atypical Meningioma After Gross Total Resection (GTR) or Subtotal Resection (STR) With or Without Postoperative Radiation Therapy (PORT)

Abstract BACKGROUND: Myxopapillary ependymomas usually occur in the filum terminale of the spinal cord. OBJECTIVE: This report summarizes our experience treating myxopapillary ependymomas. METHODS: The records of 34 patients (14 men, 20 women; mean age 45.5 years; age range, 14-88 years) who underwent resection of a myxopapillary ependymoma between 1983 and 2006 were reviewed for age, sex, tumor location, symptoms at diagnosis, duration of symptoms, treatment before presentation, extent of surgical resection, adjuvant therapy, length of follow-up, evidence of recurrence, and complications. Neurological examinations performed at presentation, immediately after surgery, and last follow-up were graded according to the McCormick grading scale. RESULTS: The average duration of symptoms before diagnosis was 22.2 months. The most common symptom was pain followed by weakness, bowel/bladder symptoms, and numbness. The rate of gross total resection was 80%. All patients with a subtotal resection (20%) underwent postoperative radiation therapy. Presentation and outcomes of patients who underwent subtotal resection followed by radiation therapy were compared with those who underwent gross total resection. There was no significant difference in neurological grade between the groups at presentation or final follow-up. The overall recurrence rate was 10% (3/34 patients). CONCLUSION: The goal of surgical treatment of myxopapillary ependymomas is resection to the greatest extent possible with preservation of function. In cases of subtotal resection, postoperative radiation therapy may improve outcome. If neurological function is maintained at treatment, these indolent lesions allow years of good function.

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Postoperative Radiation Therapy for Minor Salivary Gland Carcinomas of the Head and Neck: Long-term Outcomes

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2012.07.1332 ◽

2012 ◽

Vol 84 (3) ◽

pp. S500

Author(s):

Y. Zeidan ◽

J.D. Murphy ◽

C. Chan ◽

Y. An ◽

M. Kaplan ◽

...

Keyword(s):

Radiation Therapy ◽

Salivary Gland ◽

Head And Neck ◽

Minor Salivary Gland ◽

Postoperative Radiation ◽

Long Term Outcomes ◽

Postoperative Radiation Therapy ◽

Salivary Gland Carcinomas

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Long-term tumor control after endoscopic endonasal resection of craniopharyngiomas: comparison of gross-total resection versus subtotal resection with radiation therapy

Journal of Neurosurgery ◽

10.3171/2021.5.jns202011 ◽

2021 ◽

pp. 1-9

Author(s):

Saniya S. Godil ◽

Umberto Tosi ◽

Mina Gerges ◽

Andrew L. A. Garton ◽

Georgiana A. Dobri ◽

...

Keyword(s):

Radiation Therapy ◽

Diabetes Insipidus ◽

Endocrine Function ◽

Gross Total Resection ◽

Tumor Control ◽

Subtotal Resection ◽

Total Resection ◽

Endoscopic Endonasal

OBJECTIVE Surgical management of craniopharyngiomas (CPAs) is challenging. Controversy exists regarding the optimal goals of surgery. The purpose of this study was to compare the long-term outcomes of patients who underwent gross-total resection with the outcomes of those who underwent subtotal resection of their CPA via an endoscopic endonasal approach. METHODS From a prospectively maintained database of all endoscopic endonasal approaches performed at Weill Cornell Medicine, only patients with CPAs with > 3 years of follow-up after surgery were included. The primary endpoint was radiographic progression. Data were collected on baseline demographics, imaging, endocrine function, visual function, and extent of resection. RESULTS A total of 44 patients with a mean follow-up of 5.7 ± 2.6 years were included. Of these patients, 14 (31.8%) had prior surgery. GTR was achieved in 77.3% (34/44) of all patients and 89.5% (34/38) of patients in whom it was the goal of surgery. Preoperative tumor volume < 10 cm3 was highly predictive of GTR (p < 0.001). Radiation therapy was administered within the first 3 months after surgery in 1 (2.9%) of 34 patients with GTR and 7 (70%) of 10 patients with STR (p < 0.001). The 5-year recurrence-free/progression-free survival rate was 75.0% after GTR and 25.0% after STR (45% in subgroup with STR plus radiotherapy; p < 0.001). The time to recurrence after GTR was 30.2 months versus 13 months after STR (5.8 months in subgroup with STR plus radiotherapy; p < 0.001). Patients with GTR had a lower rate of visual deterioration and higher rate of return to work or school compared with those with STR (p = 0.02). Patients with GTR compared to STR had a lower rate of CSF leakage (0.0% vs 30%, p = 0.001) but a higher rate of diabetes insipidus (85.3% vs 50%, p = 0.02). CONCLUSIONS GTR, which is possible to achieve in smaller tumors, resulted in improved tumor control, better visual outcome, and better functional recovery but a higher rate of diabetes insipidus compared with STR, even when the latter was supplemented with postoperative radiation therapy. GTR should be the goal of craniopharyngioma surgery, when achievable with minimal morbidity.

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Long-term Outcomes of Postoperative Radiation Therapy for Major Salivary Gland Tumors

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2012.07.1343 ◽

2012 ◽

Vol 84 (3) ◽

pp. S504

Author(s):

N. Riaz ◽

L.R. Salgado ◽

E. Katsoulakis ◽

A. Ong ◽

F. Ho ◽

...

Keyword(s):

Radiation Therapy ◽

Salivary Gland ◽

Salivary Gland Tumors ◽

Major Salivary Gland ◽

Postoperative Radiation ◽

Long Term Outcomes ◽

Postoperative Radiation Therapy

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Long-term outcomes in children with glioblastoma

Journal of Neurosurgery Pediatrics ◽

10.3171/2010.5.peds09558 ◽

2010 ◽

Vol 6 (2) ◽

pp. 145-149 ◽

Cited By ~ 50

Author(s):

Kyung Sun Song ◽

Ji Hoon Phi ◽

Byung-Kyu Cho ◽

Kyu-Chang Wang ◽

Ji Yeoun Lee ◽

...

Keyword(s):

Radiation Therapy ◽

Progression Free Survival ◽

Radical Resection ◽

Tumor Location ◽

Recurrent Glioblastoma ◽

Subtotal Resection ◽

Long Term Outcomes ◽

Term Outcome ◽

Long Term Outcome

Object Glioblastoma is the most common primary malignant brain tumor; however, glioblastoma in children is less common than in adults, and little is known about its clinical outcome in children. The authors evaluated the long-term outcome of glioblastoma in children. Methods Twenty-seven children were confirmed to have harbored a glioblastoma between 1985 and 2007. The clinical features and treatment outcomes were reviewed retrospectively. All patients underwent resection; complete resection was performed in 12 patients (44%), subtotal resection in 12 patients (44%), and biopsy in 3 patients (11%). Twenty-four patients (89%) had radiation therapy, and 14 (52%) patients received chemotherapy plus radiation therapy. Among the latter, 5 patients had radiation therapy concurrent with temozolomide chemotherapy. Four patients with small-size recurrent glioblastoma received stereotactic radiosurgery. Results The median overall survival (OS) was 43 months, and the median progression-free survival was 12 months. The OS rate was 67% at 1 year, 52% at 2 years, and 40% at 5 years. The median OS was significantly associated with tumor location (52 months for superficially located tumors vs 7 months for deeply located tumors; p = 0.017) and extent of removal (106 months for completely resected tumors vs 11 months for incompletely resected tumors; p < 0.0001). Conclusions The prognosis of glioblastoma is better in children than in adults. Radical resection followed by concurrent chemoradiation therapy may be the initial treatment of choice.

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