Astrocytoma surgery
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Astrocytoma Microchapters |
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Diagnosis |
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Treatment |
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Case Study |
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Astrocytoma surgery On the Web |
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American Roentgen Ray Society Images of Astrocytoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.
Overview
Indications
- Surgical intervention is the mainstay of treatment for astrocytomas.
- Some studies suggest the resection of big tumors which are symptomatic or cause intracranial hypertension and monitor the small ones for further growth.
- Other Studies proved that early resection of the tumor at the time of diagnosis can improve patients prognosis.[1][2][3][4][5][6]
Surgery
Low grade astrocytoma
- Extensive resection is preferred over partial resection or biopsy.
- Some types of diffuse astrocytomas which are IDH mutation positive are prone to growth back if small areas of tumor cell remain after surgery.
- Because of infiltrative character of astrocytomas, complete resection may not be possible so we need chemotherapy or radiation for complete treatment.(5_9101112 management of low grade)
High grade astrocytoma
- The main goal in resection of high-grade astrocytoma is to resect all of the tumor and involved brain tissue with minimal neurological damage.
- Many studies demonstrated that extensive resection improves patient’s prognosis.
- In high grade astrocytomas which complete resection is not possible, the preferred areas for resection are contrast enhancing parts of the tumor.(14_29_30 _44_45 clinical and... highgrade)
Contraindications
The relative contraindications of brain surgery are:
- Advanced age
- Sever cardiopulmonary dysfunction
- Inaccessible lesions
- Sever systemic illness such as sepsis.(med 2 3)
References
- ↑ Whittle IR (2010). "What is the place of conservative management for adult supratentorial low-grade glioma?". Adv Tech Stand Neurosurg. 35: 65–79. PMID 20102111.
- ↑ Sanai N, Chang S, Berger MS (November 2011). "Low-grade gliomas in adults". J. Neurosurg. 115 (5): 948–65. doi:10.3171/2011.7.JNS101238. PMID 22043865.
- ↑ Aghi MK, Nahed BV, Sloan AE, Ryken TC, Kalkanis SN, Olson JJ (December 2015). "The role of surgery in the management of patients with diffuse low grade glioma: A systematic review and evidence-based clinical practice guideline". J. Neurooncol. 125 (3): 503–30. doi:10.1007/s11060-015-1867-1. PMID 26530265.
- ↑ Jakola AS, Myrmel KS, Kloster R, Torp SH, Lindal S, Unsgård G, Solheim O (November 2012). "Comparison of a strategy favoring early surgical resection vs a strategy favoring watchful waiting in low-grade gliomas". JAMA. 308 (18): 1881–8. doi:10.1001/jama.2012.12807. PMID 23099483.
- ↑ Jakola AS, Skjulsvik AJ, Myrmel KS, Sjåvik K, Unsgård G, Torp SH, Aaberg K, Berg T, Dai HY, Johnsen K, Kloster R, Solheim O (August 2017). "Surgical resection versus watchful waiting in low-grade gliomas". Ann. Oncol. 28 (8): 1942–1948. doi:10.1093/annonc/mdx230. PMC 5834105. PMID 28475680.
- ↑ Recht LD, Lew R, Smith TW (April 1992). "Suspected low-grade glioma: is deferring treatment safe?". Ann. Neurol. 31 (4): 431–6. doi:10.1002/ana.410310413. PMID 1586143.