ABSTRACT
<p><b>BACKGROUND</b>The presence of residual tumor after surgery for pituitary adenoma may necessitate further treatment. The suprasellar and parasellar extension of the tumor have been widely considered as the predictors for residual tumor. However there is scarcity of studies regarding the preoperative tumor volume and residual tumor. This study was conducted to evaluate if tumor volume could predict the outcome of transsphenoidal pituitary surgery.</p><p><b>METHODS</b>A prospective study was designed and 48 patients who underwent transsphenoidal pituitary surgery within 1 year in the First Affiliated Hospital of Xi'an Jiaotong University were included in this study. The preoperative tumor volume and immediate postoperative tumor volume (within 4 - 7 days) were calculated in the contrast magnetic resonance imaging by using the formula of ellipsoid. All these volumes were divided into three subgroups, i.e. group 1, group 2 and group 3 with preoperative volume of less than 4 cm(3), 4 - 8 cm(3), and more than 8 cm(3) respectively. The parasellar and suprasellar extension of the tumor were also classified by Knosp and modified Hardy's classifications.</p><p><b>RESULTS</b>Baseline characteristics were comparable. The preoperative tumor volume of more than 8 cm(3) (group 3, (12.1 ± 1.1) cm(3)) had increased risk on postoperative tumor residue (P < 0.01) than the other two groups ((2.1 ± 0.3) cm(3) and (6.1 ± 0.3) cm(3) in groups 1 and 2). The mean postoperative volume in group 3 patients ((2.2 ± 0.1) cm(3)) was significantly higher than the other two groups (P < 0.01).</p><p><b>CONCLUSION</b>Preoperative volume of more than 8 cm(3) can be considered as a predictor for postoperative residual volume.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Pituitary Gland , Pathology , General Surgery , Pituitary Neoplasms , Pathology , General Surgery , Prospective Studies , Treatment Outcome , Tumor Burden , PhysiologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the independent risk factors of traumatic brain injury (TBI) prognosis.</p><p><b>METHODS</b>A retrospective analysis was performed in 885 hospitalized TBI patients from January 1, 2003 to January 1,2010 in the First Affiliated Hospital of Medical College of Xi’an Jiaotong University .Single-factor and logisticregression analysis were conducted to evaluate the association of different variables with TBI outcome.</p><p><b>RESULTS</b>The single-factor analysis revealed significant association between several variables and TBI outcome, including age ( P=0.044 for the age group 40-60, Pü0.001 for the age group ≥60), complications ( P<0.001), cerebrospinal fluid leakage( P<0.001), Glasgow Coma Scale(GCS) ( P<0.001), pupillary light reflex ( P<0.001), shock ( P<0.001), associated extra-craniallesions ( P=0.01), subdural hematoma ( P<0.001), cerebral contusion ( P<0.001), diffuse axonal injury ( P<0.001), and subarachnoid hemorrhage( P<0.001), suggesting theinfluence of those factors on the prognosis of TBI. Furthermore, logistic regression analysis identified age, GCS score, pupillary light reflex, subdural hematoma,and subarachnoid hemorrhage as independent risk factors of TBI prognosis.</p><p><b>CONCLUSION</b>Age, GCS score, papillary lightreflex, subdural hematoma, and subarachnoid hemorrhage may be risk factors influencing the prognosis of TBI. Paying attention to those factors might improve the outcome of TBI in clinical treatment.</p>