脑膜瘤手术后的相对生存率。法国全国性人群队列研究。

IF 1 4区医学 Q4 CLINICAL NEUROLOGY

British Journal of Neurosurgery Pub Date : 2024-12-01 Epub Date: 2022-12-28 DOI:10.1080/02688697.2022.2159925

Charles Champeaux-Depond, Panayotis Constantinou, Philippe Tuppin, Matthieu Resche-Rigon, Joconde Weller

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引用次数: 0

摘要

背景：在报告脑膜瘤手术后的存活率时，往往没有充分考虑其他死亡原因：方法：我们处理了法国行政医疗数据库 "国家医疗数据系统"（Système National des Données de Santé），以检索脑膜瘤手术治疗患者的相关病例。采用Pohar Perme相对存活率（RS）方法：2007年至2017年间，共发现28778名患者，其中75%为女性。手术年龄中位数为59岁。颅凸是最常见的位置（24.7%），良性脑膜瘤占所有脑膜瘤的91.5%。中位随访时间为 3.5 年，四分位数范围为 [3.4-3.5]。在收集数据时，有2232名患者死亡。与年龄和性别匹配的法国标准人群的预期存活率相比，五年存活率为96.2%，置信区间（CI）[95.7-96.8]。脑膜瘤绝对超额死亡风险为 973/100,000 人年 95%CI[887-1068] (p95%CI[1.7-1.9] (p95%CI[1.27-1.54], p95%CI[0.97-0.97], p 95%CI[1.95-4.46], p 95%CI[1.36-1.42], p 95%CI[0.67-0.95], p= .0111)，术前栓塞（HR=1.3，95%CI[1.1.08-1.56]，p= .00507）、脑脊液分流（HR=2.48，95%CI[2.04-3.01]，p 95%CI[1.09-1.54]，p= .00307）或恶性组织学（HR=1.86，95%CI[1.56-2.22]，p95%CI[1.04-1.36]，p= .0122）和放疗（HR=1.43，95%CI[1.26-1.62]，p 结论：这项独特的研究凸显了与脑膜瘤疾病相关的超高死亡率。性别、年龄、位置、组织病理学分级、再次手术等许多因素都会影响 RS。

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Relative survival after meningioma surgery. A French nationwide population-based cohort study.

Background: Survival after meningioma surgery is often reported with inadequate allowance for competing causes of death.

Methods: We processed the Système National des Données de Santé, the French administrative medical database to retrieve appropriate patients' case of surgically treated meningiomas. The Pohar Perme relative survival (RS) method was implement.

Results: A total of 28,778 patients were identified between 2007 and 2017 of which 75% were female. Median age at surgery 59 years. Cranial convexity was the most common (24.7%) location and, benign meningioma represented 91.5% of all meningioma. Median follow-up was 3.5 years interquartile range [3.4-3.5]. At data collection, 2,232 patients were dead. The five-year survival relative to the expected survival of an age- and gender-matched French standard population was 96.2% _95% confidence interval (CI)[95.7-96.8]. Meningioma absolute excess risk of death was 973/100,000 person-years _95%CI[887-1068] (p< .001). The related standardised mortality ratio was 1.8 _95%CI[1.7-1.9] (p< .001). In the adjusted model, male gender (hazard ratio [HR] =1.39, _95%CI[1.27-1.54], p< .001), age at surgery (HR=0.97, _95%CI[0.97-0.97], p < .001), type 2 neurofibromatosis (HR=2.95, _95%CI[1.95-4.46], p < .001), comorbidities HR=1.39, _95%CI[1.36-1.42], p < .001), location (HR=0.8, _95%CI[0.67-0.95], p= .0111), pre-operative embolization, (HR=1.3, _95%CI[1.08-1.56], p= .00507), cerebro-spinal fluid shunt, (HR=2.48, _95%CI[2.04-3.01], p < .001), atypical (HR=1.3, _95%CI [1.09-1.54], p= .00307) or malignant histology (HR=1.86, _95%CI[1.56-2.22], p< .001), redo surgery (HR=1.19, _95%CI[1.04-1.36], p= .0122) and radiotherapy (HR=1.43, _95%CI[1.26-1.62], p < .001) were established as independent predictors of RS.

Conclusion: This unique study highlights the excess mortality associated with meningioma disease. Many factors such as gender, age, location, histopathological grading, redo surgery influence the RS.

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来源期刊

British Journal of Neurosurgery 医学-临床神经学

CiteScore

2.30

自引率

9.10%

发文量

139

审稿时长

3-8 weeks

期刊介绍： The British Journal of Neurosurgery is a leading international forum for debate in the field of neurosurgery, publishing original peer-reviewed articles of the highest quality, along with comment and correspondence on all topics of current interest to neurosurgeons worldwide. Coverage includes all aspects of case assessment and surgical practice, as well as wide-ranging research, with an emphasis on clinical rather than experimental material. Special emphasis is placed on postgraduate education with review articles on basic neurosciences and on the theory behind advances in techniques, investigation and clinical management. All papers are submitted to rigorous and independent peer-review, ensuring the journal’s wide citation and its appearance in the major abstracting and indexing services.