胶质母细胞瘤手术切除程度与患者生存预后的相关性分析

Association of extent of surgical resection with survival and prognosis in patients with glioblastoma

目的探讨胶质母细胞瘤手术切除程度对患者生存预后的影响。方法回顾性分析南京医科大学第一附属医院自2012年07月至2017年07月收治的有长期跟踪随访及术前术后磁共振影像数据完整的48例胶质母细胞瘤患者,对比分析术前术后T1增强像及Flair像,计算并分析肿瘤切除程度与患者生存预后的相关性。结果T1增强像全切的患者(切除程度100%)中位生存期(16.2月)显著长于未全切患者(<100%)的中位生存期(8.6月)(P<0.01)。进一步在T1增强像全切的患者中,基于Flair像切除率≥35%患者的中位生存期(19.7月)显著长于切除率<35%的切患者(12.4月)(P<0.05)。结论胶质母细胞瘤T1增强像全切基础上Flair像切除率≥35%能够明显延长患者的生存期,对胶质母细胞瘤手术策略制定有着重要的指导意义。

Objective To investigate the effect of extent of surgical resection on the survival and prognosis of patients with glioblastoma. Methods A retrospective analysis was performed for the clinical data of 48 patients with glioblastoma who were admitted to The First Affiliated Hospital of Nanjing Medical University from July 2012 to July 2017 and had complete long-term follow-up data and preoperative and postoperative magnetic resonance imaging( MRI) data. Preoperative and postoperative T1 enhancement images and Flair images were compared,and the association of the extent of surgical resection with survival and prognosis was analyzed. Results The patients with total resection on T1 enhancement images( an extent of resection of 100%) had a significantly longer median survival time than those without total resection( an extent of resection of < 100%)( 16. 2 months vs 8. 6 months,P < 0. 01). Among the patients with total resection on T1 enhancement images,the patients with a resection rate of ≥35% on Flair images had a significantly longer median survival time than those with a resection rate of < 35%( 19. 7 months vs 12. 4 months,P < 0. 05). Conclusions Total resection on T1 enhancement images and ≥35% resection on Flair images can significantly prolong the survival time of patients with glioblastoma,which has an important guiding significance for the development of surgical strategies for glioblastoma.