为了更好地理解由世界卫生组织(WHO)下定义的不典型脑膜瘤和恶性脑膜瘤之间的预后差异,以及第一次手术切除的分级标准对术后病程的影响,本文作者对42例不典型脑膜瘤和29例恶性脑膜瘤进行了长期随访研究。两组病例分别作了长期生存率、...为了更好地理解由世界卫生组织(WHO)下定义的不典型脑膜瘤和恶性脑膜瘤之间的预后差异,以及第一次手术切除的分级标准对术后病程的影响,本文作者对42例不典型脑膜瘤和29例恶性脑膜瘤进行了长期随访研究。两组病例分别作了长期生存率、无复发生存期和复发的中位生存期(median time to recurrence)的比较。对肿瘤部位及手术切除的Simpson分级也作了考虑。不典型脑膜瘤的5年和10年生存率分别为95％和79％,而恶性脑膜瘤则分别为64.3％和34.5％(P=0.001)。不典型脑膜瘤的无复发生存期和复发的中位期也明显长于恶性脑膜瘤,分别为11.9年对2年(P=0.001)。和5年对2年(P【0.0041),23例复发的不典型脑膜瘤中6例(26％)变为恶性。在全组病例中在大脑凸面及SimpsonⅠ级切除肿瘤者有良好的临床过程(P≤0.0016)。不典型脑膜瘤的预后较之不完全切除的恶性脑膜瘤(SimpsonⅡ～Ⅲ级)者为好,但此种差别无统计学意义。应用Cox法多变数分析表明根除性切除肿瘤(SimpsonⅠ级对Ⅱ～Ⅲ级)和组织学所见(不典型脑膜瘤对恶性脑膜瘤)与长期生存有明显关系(P值分别【0.0003及0.0388)。结论:本研究表明多数不典型脑膜瘤病人的预后较恶性脑膜瘤者为好,但对前者切除不完全的复发性及恶性变的危险性不容忽视(26％)。此外,WHO的分类对于少?展开更多
In recent decades,haploidentical stem cell transplantation(haplo-SCT)to treat severe aplastic anemia(SAA)has achieved remarkable progress.However,long-term results are still lacking.We conducted a multicenter prospect...In recent decades,haploidentical stem cell transplantation(haplo-SCT)to treat severe aplastic anemia(SAA)has achieved remarkable progress.However,long-term results are still lacking.We conducted a multicenter prospective study involving SAA patients who underwent haplo-SCT as salvage therapy.Long-term outcomes were assessed,mainly focusing on survival and quality of life(QoL).Longitudinal QoL was prospectively evaluated during pretransplantation and at 3 and 5 years posttransplantation using the SF-36 scale in adults and the PedsQL 4.0 scale in children.A total of 287 SAA patients were enrolled,and the median follow-up was 4.56 years(range,3.01–9.05 years)among surviving patients.During the long-term follow-up,268 of 275 evaluable patients(97.5%)obtained sustained full donor chimerism,and 93.4%had complete hematopoietic recovery.The estimated overall survival and failure-free survival for the whole cohort at 9 years were 85.4%±2.1%and 84.0%±2.2%,respectively.Age(≥18 years)and a poorer performance status(ECOG>1)were identified as risk factors for survival outcomes.For Qo L recovery after haplo-SCT,we found that QoL progressively improved from pretransplantation to the 3-year and 5-year time points with statistical significance.The occurrence of chronic graft versus host disease was a risk factor predicting poorer QoL scores in both the child and adult cohorts.At the last followup,74.0%of children and 72.9%of adults returned to normal school or work.These inspiring long-term outcomes suggest that salvage transplantation with haploidentical donors can be routine practice for SAA patients without human leukocyte antigen(HLA)-matched donors.展开更多
文摘为了更好地理解由世界卫生组织(WHO)下定义的不典型脑膜瘤和恶性脑膜瘤之间的预后差异,以及第一次手术切除的分级标准对术后病程的影响,本文作者对42例不典型脑膜瘤和29例恶性脑膜瘤进行了长期随访研究。两组病例分别作了长期生存率、无复发生存期和复发的中位生存期(median time to recurrence)的比较。对肿瘤部位及手术切除的Simpson分级也作了考虑。不典型脑膜瘤的5年和10年生存率分别为95％和79％,而恶性脑膜瘤则分别为64.3％和34.5％(P=0.001)。不典型脑膜瘤的无复发生存期和复发的中位期也明显长于恶性脑膜瘤,分别为11.9年对2年(P=0.001)。和5年对2年(P【0.0041),23例复发的不典型脑膜瘤中6例(26％)变为恶性。在全组病例中在大脑凸面及SimpsonⅠ级切除肿瘤者有良好的临床过程(P≤0.0016)。不典型脑膜瘤的预后较之不完全切除的恶性脑膜瘤(SimpsonⅡ～Ⅲ级)者为好,但此种差别无统计学意义。应用Cox法多变数分析表明根除性切除肿瘤(SimpsonⅠ级对Ⅱ～Ⅲ级)和组织学所见(不典型脑膜瘤对恶性脑膜瘤)与长期生存有明显关系(P值分别【0.0003及0.0388)。结论:本研究表明多数不典型脑膜瘤病人的预后较恶性脑膜瘤者为好,但对前者切除不完全的复发性及恶性变的危险性不容忽视(26％)。此外,WHO的分类对于少?
基金supported by the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(81621001)the National Natural Science Foundation of China(82100227)+1 种基金the Key Program of National Natural Science Foundation of China(81930004)the National Key Research and Development Program of China(2017YFA0104500)。
文摘In recent decades,haploidentical stem cell transplantation(haplo-SCT)to treat severe aplastic anemia(SAA)has achieved remarkable progress.However,long-term results are still lacking.We conducted a multicenter prospective study involving SAA patients who underwent haplo-SCT as salvage therapy.Long-term outcomes were assessed,mainly focusing on survival and quality of life(QoL).Longitudinal QoL was prospectively evaluated during pretransplantation and at 3 and 5 years posttransplantation using the SF-36 scale in adults and the PedsQL 4.0 scale in children.A total of 287 SAA patients were enrolled,and the median follow-up was 4.56 years(range,3.01–9.05 years)among surviving patients.During the long-term follow-up,268 of 275 evaluable patients(97.5%)obtained sustained full donor chimerism,and 93.4%had complete hematopoietic recovery.The estimated overall survival and failure-free survival for the whole cohort at 9 years were 85.4%±2.1%and 84.0%±2.2%,respectively.Age(≥18 years)and a poorer performance status(ECOG>1)were identified as risk factors for survival outcomes.For Qo L recovery after haplo-SCT,we found that QoL progressively improved from pretransplantation to the 3-year and 5-year time points with statistical significance.The occurrence of chronic graft versus host disease was a risk factor predicting poorer QoL scores in both the child and adult cohorts.At the last followup,74.0%of children and 72.9%of adults returned to normal school or work.These inspiring long-term outcomes suggest that salvage transplantation with haploidentical donors can be routine practice for SAA patients without human leukocyte antigen(HLA)-matched donors.
