Short-term preoperative treatment of macroprolactinomas by dopamine agonists

✓ During a period of 3 years, 25 patients with intra- and extrasellar macroprolactinomas were pretreated with dopamine agonists for a period of 2 to 6½ weeks prior to transsphenoidal microsurgical tumor resection. Dopamine agonists were administered orally to 17 patients, intramuscularly to three patients, and both orally and intramuscularly to five patients. Repeated computerized tomography (CT) examinations revealed that all neoplasms except one cystic tumor were reduced in size during the course of dopamine-agonist administration. No complications attributable to medical pretreatment were observed. Tumor shrinkage increased the efficacy of surgery, especially in cases with considerable extrasellar extension of the adenomas. Within 3 months following adenomectomy, prolactin levels were adjusted to normal levels in 19 patients by additional low-dose treatment with dopamine agonists. Thin-collimation CT assessments performed at least 3 months after surgery showed no evidence of residual tumor tissue in 23 patients. It is concluded that administration of dopamine agonists for some weeks prior to surgery is a useful adjunct to transsphenoidal microsurgery for macroprolactinomas. The new injectable form of bromocriptine is particularly valuable for this purpose.

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Volume of residual disease as a predictor of outcome in adult patients with recurrent supratentorial glioblastomas multiforme who are undergoing chemotherapy

Journal of Neurosurgery ◽

10.3171/jns.2004.100.1.0041 ◽

2004 ◽

Vol 100 (1) ◽

pp. 41-46 ◽

Cited By ~ 79

Author(s):

G. Evren Keles ◽

Kathleen R. Lamborn ◽

Susan M. Chang ◽

Michael D. Prados ◽

Mitchel S. Berger

Keyword(s):

Survival Rate ◽

Residual Disease ◽

Prognostic Significance ◽

Tumor Resection ◽

Progression Free Survival ◽

Residual Tumor ◽

Adult Patients ◽

Content Type ◽

Response To Chemotherapy ◽

Fine Print

Object. For patients with recurrent glioblastomas multiforme (GBMs) the prognosis is poor. Although chemotherapy may provide a survival advantage, the role of the extent of tumor resection, or the volume of the residual tumor at the time of recurrence, before instituting chemotherapy, is unclear. This study was designed to assess the response to chemotherapy based on the volume of residual disease (VRD) at the start of treatment in patients with recurrent GBMs. To accomplish this, the authors evaluated a homogeneous group of patients with recurrent GBMs who received the same chemotherapeutic agent. Methods. One hundred nineteen adult patients with recurrent supratentorial GBMs received temozolomide chemotherapy at the time of tumor recurrence. In this cohort the authors analyzed the prognostic significance of volumetrically assessed tumor mass on time to tumor progression (TTP) and survival time (ST). Multivariate analysis demonstrated that the VRD at the beginning of chemotherapy was a statistically significant predictor of both TTP (p < 0.0001) and ST (p < 0.006) when adjusted for the patient's age, performance score, and time from the initial diagnosis. Patients in whom the VRD was less than 10 cm3 at the start of chemotherapy had a 6-month progression-free survival rate of 32% compared with 8% for patients with a VRD between 10 and 15 cm3 and 3% for patients with a VRD larger than 15 cm3. Patients in whom the VRD was smaller than 10 cm3 had a 1-year survival rate of 37% compared with 9% for patients with a VRD between 10 and 15 cm3 and 18% for patients with a VRD larger than 15 cm3. Conclusions. These data indicate that patients with recurrent GBMs who start chemotherapy with a smaller volume (< 10 cm3) of residual disease may have a more favorable response to chemotherapy and a more favorable outcome.

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Transsphenoidal surgery and adjuvant gamma knife treatment for growth hormone—secreting pituitary adenoma

Journal of Neurosurgery ◽

10.3171/jns.2001.95.2.0285 ◽

2001 ◽

Vol 95 (2) ◽

pp. 285-291 ◽

Cited By ~ 66

Author(s):

Hidetoshi Ikeda ◽

Hidefumi Jokura ◽

Takashi Yoshimoto

Keyword(s):

Growth Hormone ◽

Pituitary Adenoma ◽

Mr Imaging ◽

Transsphenoidal Surgery ◽

Residual Tumor ◽

Cure Rate ◽

Content Type ◽

Transsphenoidal Microsurgery ◽

Biochemical Cure ◽

Fine Print

Object. The results of combined transsphenoidal surgery and adjuvant gamma knife surgery (GKS) for growth hormone (GH)—secreting adenoma were investigated using biochemical cure criteria for surgery and biological cure criteria for adjuvant GKS. Methods. Ninety patients (42 male and 48 female patients), ranging from 11 to 75 years of age, underwent transsphenoidal surgery for GH-secreting pituitary adenoma. Preoperative and postoperative GH and insulin-like growth factor-I levels were measured, as was the postoperative GH level after the oral glucose tolerance test. Tumor size, cavernous sinus (CS) invasion, and residual tumor were evaluated using magnetic resonance (MR) imaging. Transsphenoidal microsurgery was performed, followed by adjuvant GKS when there was persistent biochemical evidence of GH hypersecretion with residual tumor detectable in the CS on MR imaging. Patients in whom GKS was contraindicated were treated with conventional radiotherapy or by medical means. Conclusions. The overall surgical cure rate was 57% based on recently accepted biochemical cure criteria. Patients with no CS invasion achieved a 100% cure rate, whereas patients with CS invasion achieved an 82% cure rate (14 of 17 patients) after adjuvant GKS. The combination of transsphenoidal microsurgery and adjuvant GKS is the optimal therapy for patients with GH-secreting adenoma.

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Extracorporeal irradiation of tumorous calvaria

Journal of Neurosurgery ◽

10.3171/jns.2000.93.3.0494 ◽

2000 ◽

Vol 93 (3) ◽

pp. 494-497 ◽

Cited By ~ 1

Author(s):

Matthew A. Manning ◽

Robert M. Cardinale ◽

Rupert K. Schmidt-Ullrich ◽

Brian D. Kavanagh ◽

Isaac L. Wornom ◽

...

Keyword(s):

Tumor Resection ◽

Residual Tumor ◽

Frontal Bone ◽

High Dose ◽

Content Type ◽

Prosthetic Implants ◽

Cadaveric Transplantation ◽

Extracorporeal Irradiation ◽

Very High ◽

Fine Print

✓ This patient with recurrent meningioma grossly involving the frontal bone underwent craniotomy and tumor resection. During the procedure a bone flap was irradiated extracorporeally at a very high dose (120 Gy) sufficient to sterilize residual tumor cells, and the bone was then successfully replaced orthotopically for reconstruction. The use of autologous irradiated bone in this setting offers advantages over cadaveric transplantation and prosthetic implants. Radiation might cause less disruption of the bone's architecture than other techniques of tumor cell eradication.

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Adult sacrococcygeal teratoma excised by endoscopic surgery with a transsacral approach: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01263-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Ryosuke Machi ◽

Chikashi Hiranuma ◽

Hayato Suzuki ◽

Masakazu Hattori ◽

Kenji Doden ◽

...

Keyword(s):

Histopathological Examination ◽

Mature Teratoma ◽

Tumor Resection ◽

Residual Tumor ◽

Cystic Mass ◽

Cystic Tumor ◽

Sacrococcygeal Teratoma ◽

Transsacral Approach ◽

Surgical Field ◽

Magnetic Resonance Imaging Mri

Abstract Background Although sacrococcygeal teratoma (SCT) is relatively common in children, it is rare in adults. The prognosis for malignant cases is poor, so prompt surgical resection is required. Transabdominal and transsacral approaches are common approaches for tumor resection. In recent years, there have been reports of tumor removal with laparoscopic assistance, but all have applied transabdominal approaches. Case presentation A 27-year-old woman visited our gynecology department because of abdominal pain and genital bleeding. Magnetic resonance imaging (MRI) revealed a 3-cm-sized cystic mass in the left retrorectal area, and she was referred to our department for detailed examinations and treatment. She was diagnosed with a presacral cystic tumor and decided to undergo surgery. We used a transsacral approach to perform tumor excision. Since it was difficult to confirm the deep part of the tumor through direct visualization, we used GelPOINT® Path (a transanal access platform) and AirSEAL® System (insufflation device) to remove the tumor endoscopically. The postoperative course was uneventful with no bladder or rectal dysfunction. Histopathological examination revealed a mature teratoma. Conclusions When the tumor is relatively small and located in the lower sacrum, the endoscopically assisted transsacral approach can establish a stable field of view by expanding the depth of the surgical field. This method is useful considering its ability to perform excision without leaving residual tumor tissue and satisfactory safety and cosmetic results.

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Short-term, low-dose ACTH therapy in West syndrome

Neuropediatrics ◽

10.1055/s-2005-868046 ◽

2005 ◽

Vol 36 (02) ◽

Author(s):

G Ramantani ◽

M Tzitiridou ◽

C Panteliadis

Keyword(s):

Low Dose ◽

West Syndrome ◽

Short Term ◽

Acth Therapy

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THE VALUE OF SKELETAL MUSCLE MASS IN PREDICTING SHORT-TERM OUTCOMES OF SURGICAL TREATMENT FOR KLATSKIN TUMOR

Problems in oncology ◽

10.37469/0507-3758-2018-64-5-564-569 ◽

2018 ◽

Vol 64 (5) ◽

pp. 564-569

Author(s):

Yuriy Zharikov ◽

Tatyana Zharikova ◽

Vladimir Nikolenko

Keyword(s):

Skeletal Muscle ◽

Surgical Treatment ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Negative Impact ◽

Treatment Algorithm ◽

Preoperative Treatment ◽

Klatskin Tumor ◽

Short Term ◽

Oncological Patients

The objective of this review study was to analyze the relationship between skeletal muscle mass and postoperative short-term outcomes morbidity in patients with Klatskin tumor who underwent surgical treatment. Low index skeletal muscle mass had a negative impact factor on postoperative morbidity following resection of Klatskin tumor and should therefore be considered as preoperative risk assessment. The further study of body composition in oncological patients allowed revealing the group of patients with high probability of postoperative complications and this factor needed to be added to future models predictive scale of short-term outcomes with the aim of making the most rational preoperative treatment algorithm.

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Bioactive Peptides Sensitize Cells to Anticancer Effects of Oxaliplatin in Human Colorectal Cancer Xenografts in Nude Mice

Protein and Peptide Letters ◽

10.2174/0929866526666190405124955 ◽

2019 ◽

Vol 26 (7) ◽

pp. 512-522

Author(s):

Xian Li ◽

Long Xia ◽

Xiaohui Ouyang ◽

Qimuge Suyila ◽

Liya Su ◽

...

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Nude Mice ◽

Low Dose ◽

Bioactive Peptides ◽

Human Colorectal Cancer ◽

Short Term ◽

Hct 116

Background: Despite new agent development and short-term benefits in patients with Colorectal Cancer (CRC), metastatic CRC cure rates have not improved due to high rates of oxaliplatin resistance and toxicity. There is an urgent need for effective tools to prevent and treat CRC and reduce morbidity and mortality of CRC patients. Exploring the effects of bioactive peptides on the antitumor to CRC was of vital importance to the clinical application. Objective: This study aimed to investigate the therapeutic impact of Anticancer Bioactive Peptides (ACBP) on anticancer effect of oxaliplatin (LOHP) in human colorectal cancer xenografts models in nude mice. Methods: HCT-116 cells were cultured in vitro via CCK-8 assays and the absorbance was measured at 450 nm. Apoptosis and cell cycle were assessed by Flow Cytometry (FCM) in vitro. HCT-116 human colorectal cancer cells inoculated subcutaneously in nude mice of treatment with PBS (GG), ACBP, LOHP, ACBP+LOHP (A+L) in vivo. The quality of life was assessed by dietary amount of nude mice, the weight of nude mice, inhibition rates, tumor weight and tumor volume. Immunohistochemistry and RT-qPCR method was conducted to determine the levels of apoptosisregulating proteins/genes in transplanted tumors. Results: ACBP induced substantial reductions in viable cell numbers and apoptosis of HCT116 cells in combined with LOHP in vitro. Compared with the control GG group, ACBP combined low dose oxaliplatin (U) group demonstrated significantly different tumor volume, the rate of apoptosis, the expression levels of Cyt-C, caspase-3,8,9 proteins and corresponding RNAs (P<0.05). The expression of pro-apoptotic proteins in the cytoplasm around the nucleus was significantly enhanced by ACBP. Short term intermittent use of ACBP alone indicted a certain inhibitory effect on tumor growth, and improve the quality of life of tumor bearing nude mice. Conclusion: ACBP significantly increased the anti-cancer responses of low dose oxaliplatin (L-LOHP), thus, significantly improving the quality of life of tumor-bearing nude mice.

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Recurrent Sphenocavernous Meningioma

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0041-1725941 ◽

2021 ◽

Author(s):

Mizuho Inoue ◽

Mohamed Labib ◽

Alexander Yang ◽

A. Samy Youssef

Keyword(s):

Tumor Resection ◽

Intensity Modulated Radiotherapy ◽

Residual Tumor ◽

World Health ◽

Neurological Deficits ◽

Falciform Ligament ◽

Total Resection ◽

Anterior Clinoid Process ◽

Who Grade ◽

Health Organization

AbstractA case of a recurrent sphenocavernous meningioma is presented. The patient is a 42-year-old male who presented with an episode of transient right-sided numbness. A magnetic resonance imaging (MRI) revealed a large left sphenocavernous meningioma. The patient underwent a frontotemporal craniotomy for tumor resection. Near total resection was achieved with minimal residual in the left cavernous sinus (CS) and orbital apex. The pathology was consistent with meningioma, World Health Organization (WHO) grade I. A follow-up MRI was done 9 months after surgery and showed a growth of the residual tumor, which was treated with intensity modulated radiotherapy. Tumor growth was detected on serial imaging over a 4-year period. Surgical resection was offered. A left frontotemporal craniotomy with pretemporal transcavernous approach was performed. The bone flap was reopened and the dura was opened in a Y-shaped fashion. The roof of the optic canal was drilled off, and the falciform ligament was opened to decompress the optic nerve. The tumor was disconnected from the anterior clinoid region (the anterior clinoid process was eroded by the tumor) and reflected off the wall of the lateral CS. Tumor was adherent to the V2 fascicles (the lateral CS wall was resected in the first surgery) and was sharply dissected off. Gross total resection was achieved. The pathology was consistent with meningioma, WHO grade I. The patient had an unremarkable postoperative course without any new neurological deficits.The link to the video can be found at: https://youtu.be/KVBVw_86JqM.

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