Abstract
Objective. To assess the significance of clinical factors of extramedullary tumors and new methods of their resection as potential predictors of their recurrence and continued growth.Material and Methods. The long-term results of removal of primary extramedullary tumors in 412 patients operated on in 1998–2014 were analyzed comparing the use of standard methods of microsurgical technique for tumor removal (277 patients) and of those with additional use of neodymium laser radiation (135 patients).Results. The use of laser technologies for resection of extramedullary tumors can significantly reduce the number of their recurrences and continued growth, along with other clinical factors is a significant prognostic indicator in determining the nature of the disease course and can be a predictor of their occurrence. The most reliable clinical factors determining the prognosis of a decrease in the incidence of recurrences and continued growth when using laser techniques of surgical resection were repeated operations (p = 0.002), the presence of ependymomas of the cone and cauda equina (p = 0.017), operations for primary tumors in the thoracic spine (p = 0.039) and extramedullary tumors with Grade I anaplasia (p = 0.007). An increase in the number of these conditions was associated with operations on the cervical spine (p = 0.027), the presence of a tumor with Grade II anaplasia (p = 0.007), and a primary extramedullary tumor involving more than three vertebrae (p = 0.017).Conclusion. The use of the laser is indicated for reoperations when removing neoplasms, that have arisen as a result of recurrence or continued growth of extramedullary tumors of any level and length after removal of primary neoplasms with a Grade I malignancy confirmed by intraoperative cytological examination involving no more than three vertebrae in the thoracic, lumbar and sacral spine and during resection of ependymomas with extramedullary growth.
Highlights
The most reliable clinical factors determining the prognosis of a decrease in the incidence of recurrences and continued growth when using laser techniques of surgical resection were repeated operations (p = 0.002), the presence of ependymomas of the cone and cauda equina (p = 0.017), operations for primary tumors in the thoracic spine (p = 0.039) and extramedullary tumors with Grade I anaplasia (p = 0.007)
Особенно обращает на себя внимание фактор субтотального удаления, повышающий риск продолженного роста во всей серии в 115,5 раза, а в группе сравнения – в 60,55 раза
Цивьяна проводит индивидуальное тематическое обучение на рабочем месте в виде краткосрочных курсов повышения квалификации по следующим циклам: 363-39-81
Summary
To assess the significance of clinical factors of extramedullary tumors and new methods of their resection as potential predictors of their recurrence and continued growth. Влияющие на развитие рецидивов и продолженный рост первичных экстрамедуллярных опухолей I.A. Eliseenko et al Factors influencing the development of recurrence and continued growth of primary extramedullary tumors and can be a predictor of their occurrence. The most reliable clinical factors determining the prognosis of a decrease in the incidence of recurrences and continued growth when using laser techniques of surgical resection were repeated operations (p = 0.002), the presence of ependymomas of the cone and cauda equina (p = 0.017), operations for primary tumors in the thoracic spine (p = 0.039) and extramedullary tumors with Grade I anaplasia (p = 0.007). Частота встречаемости экстрамедуллярных опухолей составляет 70–80 % от всех случаев первичных опухолевых заболеваний спинного мозга и 53,0– 68,5 % от общего числа спинно-мозговых новообразований [3]. Цель исследования – оценка значимости клинических факторов экстрамедуллярных опухолей и новых методов их резекции как потенциальных предикторов возникновения рецидивов и продолженного роста данных новообразований
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