ABSTRACT
Objective To evaluate the feasibility and safety of supratotal resection of frontal or temporal lobe glioblastoma by the postoperative cognitive function and overall survival. Methods The clinical data of patients with frontal or temporal lobe glioblastoma and treated from January 2010 to January 2015 were analyzed retrospectively.The patients underwent supratotal resection of glioblastoma after March 2012(trial group, 33 cases). Before March 2012, the patients underwent total resection of glioblastoma(control group,28 cases).The Montreal cognitive assessment(MoCA)scores before operation and the 7th day after operation were used to evaluate the security, while overall survival was used to evaluate the feasibility. Variance analysis of repeated measurement quantitative data was used for the statistical analysis of the results. Multivariate Cox model was used as a method to estimate the independent association of a variable set with overall survival. Survival time observation was plotted by the Kaplan-Meier analysis,starting from the data of surgery.Results The MoCA scores in control group at the 7th day after operation were significantly lower than those before operation:(25.39 ± 3.04)scores vs.(26.67 ± 2.19)scores, t = 4.446,P < 0.05. The MoCA scores in trial group at the 7th day after operation were significantly lower than those before operation:(21.93 ± 4.46)scores vs.(25.39 ± 3.04) scores,t = 3.485,P < 0.05. The survival analysis of Kaplan-Meier method showed that age, surgical method and preoperative KPS scores were statistically significant (P < 0.05). Cox regression analysis showed that the choice of surgical method and preoperative KPS was 0.286 and 0.965,respectively.The risk of death in control group was 0.286 times of that in trial group.The survival time of trial group was better than that of control group.Conclusions The cognitive function of patients with frontal or temporal glioblastoma may have a certain degree of decline after tumor resection or supratotal resection.Supratotal resection could represent a promising strategy that can impact on outcome in glioblastoma patients. Supratotal resection could be a factor influencing survival.
ABSTRACT
Objective To examine the clinical factors associated with postoperative outcome in dementia combined with cerebral amyloid angiopathy-related intracerebral hemorrhage (CAA-ICH). Methods The clinical data of 25 surgical patients of dementia combined with CAA-ICH were retrospectively analyzed. The postoperative short-term effects and long-term effects were evaluated at the 30 d and 6 months after operation according to the modified Rankin score (MRS), and the influencing factors were analyzed. Results Among the 25 patients, eusemia was in 6 cases. Age ≥ 75 years, Glasgow coma score (GCS) ≤ 8 scores on admission, hypertension, postoperative anemia, pulmonary diseases, midline shift were the influencing factors of postoperative short-term effects (P < 0.05 or <0.01). Twenty-two patients were followed up for 6 months, and ensemia was in 9 cases. Age≥75 years, GCS ≤ 8 scores on admission, hypertension, postoperative anemia, hypoproteinemia and pulmonary diseases were the influencing factors of postoperative long-term effects (P<0.01 or<0.05). Conclusions Preoperative assessment is important for the patients of dementia combined with CAA-ICH. Age ≥ 75 years, GCS ≤ 8 socres on admission, hypertension, postoperative anemia, pulmonary diseases, midline shift are associated with poor short-term effects; age ≥ 75 years, GCS ≤ 8 scores on admission,hypertension, postoperative anemia, hypoproteinemia and pulmonary diseases are associated with poor long-term effects.