脊髓胶质瘤伴颅内转移的临床特征及预后：基于个案的综合分析。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-06-25 DOI:10.1016/j.wneu.2025.124205

Jiaoming Li , Tao Chang , Yan Zeng , Weichao Ma , Jingsong Liu , Tianjian Ren , Xiaodong Niu

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引用次数: 0

摘要

目的：探讨罕见脊髓胶质瘤伴颅内转移（IM）的临床病理特征及生存预测因素，以指导临床决策和优化治疗策略。方法：根据已发表的病例和病例系列，对62例经组织病理学证实的脊髓胶质瘤（低级别12例，高级别50例）进行回顾性分析。生存结果分析采用Kaplan-Meier方法与时间相关变量。Kaplan-Meier分析用于评估生存模式，Cox比例风险回归用于确定与生存结果相关的预后因素。结果：单因素分析显示，症状持续时间和EOR显著影响DTIM （EOR为独立因素，p < 0.05）。总生存期（OS）分析显示，IM部位、病理类型和IMTO对患者预后有显著影响（p < 0.05）。多因素分析证实DTIM和IMTO是OS的独立预测因子（p < 0.05）。结论：最大限度的安全切除和辅助治疗仍然是至关重要的。通过量身定制的治疗策略延长DTIM和IMTO可显著提高脊髓胶质瘤合并颅内转移（IM）患者的生存结果。

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Clinical Characteristics and Prognostic Outcomes of Spinal Cord Gliomas with Intracranial Metastasis: An Integrated Analysis Based on Individual Cases

Objective

To characterize the clinicopathological features and identify survival predictors in rare spinal cord gliomas (SCGs) with intracranial metastasis (IM), with the goal of guiding clinical decision-making and optimizing management strategies.

Methods

A retrospective analysis was conducted on 62 histopathologically verified SCGs (12 low-grade and 50 high-grade) with IM based on published cases and case series. Survival outcomes were analyzed using Kaplan-Meier methods with time-dependent variables. Kaplan-Meier analysis was used to evaluate survival patterns, and Cox proportional hazards regression was applied to identify prognostic factors associated with survival outcomes.

Results

Univariate analysis showed symptom duration and extent of resection significantly affected diagnosis-to-intracranial metastasis (DTIM) (extent of resection as an independent factor, P < 0.05). Overall survival analysis demonstrated that the IM site, pathology type, and intracranial metastasis-to-outcome (IMTO) significantly influenced patient prognosis (P < 0.05). Multivariate analysis confirmed DTIM and IMTO as independent predictors of overall survival (P < 0.05).

Conclusions

Maximal safe resection with adjuvant therapy remains of paramount importance. Extending the DTIM and IMTO through tailored therapeutic strategies significantly enhances survival outcomes in patients with SCGs complicated by IM.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS