scholarly journals The role of surgery in primary central nervous system lymphomas

2018 ◽  
Vol 76 (3) ◽  
pp. 139-144 ◽  
Author(s):  
Juan Francisco Villalonga ◽  
Lucas Alessandro ◽  
Mauricio Franco Farez ◽  
Rubén Mormandi ◽  
Andrés Cervio ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Retrospective Study ◽  
Survival Time ◽  
Surgical Resection ◽  
Median Survival Time ◽  
Traditional Treatment ◽  
Resection Group ◽  
Improvement In Survival

ABSTRACT Background Primary central nervous system lymphomas (PCNSL) are infrequent. The traditional treatment of choice is chemotherapy. Complete resections have generally not been recommended, because of the risk of permanent central nervous system deficits with no proven improvement in survival. The aim of the current study was to compare survival among patients with PCNSL who underwent biopsy versus surgical resection. Methods A retrospective study was conducted on 50 patients with a confirmed diagnosis of PCNSL treated at our center from January 1994 to July 2015. Results Patients in the resection group exhibited significantly longer median survival time, relative to the biopsy group, surviving a median 31 months versus 14.5 months; p = 0.016. Conclusions In our series, patients who had surgical resection of their tumor survived a median 16.5 months longer than patients who underwent biopsy alone.

Colorectal Plasmacytomas: A Retrospective Study of Nine Dogs

2006 ◽  
Vol 42 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Patricia A. Kupanoff ◽  
Catherine A. Popovitch ◽  
Michael H. Goldschmidt
Keyword(s):  
Retrospective Study ◽  
Local Recurrence ◽  
Survival Time ◽  
Surgical Resection ◽  
Median Survival ◽  
Median Survival Time ◽  
Complete Excision ◽  
Complete Surgical Resection

Nine cases of colorectal plasmacytomas diagnosed between 1998 and 2001 were reviewed. Treatment consisted of complete surgical resection when possible. Two dogs had multiple plasmacytomas. Two dogs had local recurrence of the tumor at 5 and 8 months after resection. Two dogs were alive at 20 and 23 months with no recurrences at the time of follow-up. The median survival time was 15 months (range 5 to 33 months). Colorectal plasmacytomas are similar to mucocutaneous plasmacytomas, in that they tend to progress slowly and do not recur with complete excision.

scholarly journals SURG-10. The evolving role of neurosurgery for central nervous system metastases in the era of personalized medicine

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii25-iii25
Author(s):  
Philipp Karschnia ◽  
Emilie Le Rhun ◽  
Stefan J Grau ◽  
Matthias Preusser ◽  
Riccardo Soffietti ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Personalized Medicine ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Surgical Resection ◽  
Current Status ◽  
Unknown Primary ◽  
Mixed Response

Abstract Background Novel therapies translating into improved survival of patients with advanced cancer have emerged. The number of metastases in the central nervous system is therefore seen to increase. Neurosurgery assumes an expanding role within multi-disciplinary care structures for such patients. Methods We performed a comprehensive literature review on the current status of neurosurgery for brain metastases patients. Based on the extracted data, we developed a review from experts in the field on the role of brain metastasis surgery in the era of personalized medicine. Results Traditionally, three metastases were considered the cutoff to offer surgical resection. With respect to the clinical status, the resection of a symptomatic mass may nowadays be considered even in presence of multiple tumors in a multimodal setting: surgical resection of brain metastasis provides immediate relief from mass effect-related symptoms and histology in case of unknown primary tumor; surgery may help stabilizing the disease, thus enabling further therapy; and in situations where immunotherapy is considered and non-surgical management would require long-term steroid administration, surgery may also provide expeditious relief of edema and reduction of needs for steroids. In patients with multiple brain metastasis and mixed response to non-surgical therapy, tumor resampling may allow tissue analysis for expression of molecular tumor targets. In patients with leptomeningeal dissemination and consecutive hydrocephalus, ventriculo-peritoneal shunting improves quality of life but also allows for time to administer more therapy thus prolonging survival. Addressing the limited efficacy of many oncological drugs for brain metastases, clinical trial protocols in which surgical specimens are analyzed for pre-surgically administered agents may offer pharmacodynamic insights. Conclusion Comprehensive neurosurgical care will have to be an integral element of multi-disciplinary oncological centres providing care to patients with brain metastases to improve on therapy and tumour biology research.

scholarly journals The role of surgical resection in primary central nervous system lymphoma: a single-center retrospective analysis of 70 patients

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shiqiang Wu ◽  
Junwen Wang ◽  
Weihua Liu ◽  
Feng Hu ◽  
Kai Zhao ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Prognostic Factors ◽  
Surgical Resection ◽  
Stereotactic Biopsy ◽  
Multivariable Analysis ◽  
Central Nervous System Lymphoma ◽  
Brain Biopsy ◽  
Resection Group ◽  
Selection For

Abstract Background The aim of this study was to evaluate the effect of surgical resection and stereotactic biopsy on the complication rate, progression-free survival (PFS) and overall survival (OS) of 70 patients diagnosed at a single institution with primary central nervous system lymphoma (PCNSL) and to explore the predictors of selection for resection and the prognostic factors of PCNSL. Methods A retrospective analysis was performed of 70 patients with PCNSL that was diagnosed by surgical resection or stereotactic brain biopsy in our department from January 2013 to May 2019. We divided the patients into two groups: a resection group (n = 28) and a stereotactic biopsy group (n = 42). Data on clinical characteristics, imaging findings, complication rates, PFS and OS were retrospectively reviewed and compared between these two groups. We also analysed the predictors of selection for resection and prognostic factors of PCNSL by multivariate analysis. Results The median age was 53.3 ± 14.3 years, and there was a male predominance with a sex ratio of 1.33:1. The most common clinical manifestation was a headache. The complication rate in the resection group was 10.7% versus 7.1% in the stereotactic biopsy group, and there was no statistically significant difference. The rate of improvement in symptoms of the resection group was significantly higher than that of the stereotactic biopsy group. Multivariable analysis identified a single tumour and not involving deep structures as predictors of selection for resection. With a median follow-up of 30 months (range 1–110), the mean OS and PFS of all patients were 16.1 months and 6.2 months, respectively. Patients who underwent surgical resection had a mean OS of 23.4 months and PFS of 8.6 months versus 11.2 months and 4.6 months for those who had a brain biopsy performed. In addition, multivariable analysis showed that not involving deep structures and resection were favourable prognostic factors for PCNSL. Conclusions The outcomes of patients with PCNSL treated in our cohort are still poor. In our series, surgical resection might play a role in significantly improving OS and PFS compared with stereotactic biopsy in a subset of patients. The type of surgery and tumour location are prognostic factors for PCNSL.

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