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,体积程度上ofresection(vEOR) goals have not been established for these reoperations, and retrospective studies have failed to demonstrate a survival benefit from postoperative RT for recurrent tumors. 8 – 11 An additional subsetofpatients possesses recurrent atypical meningiomas that have transformed from a previous diagnosisofWorld Health Organization (WHO) grade I. The effectofreresection on these pathologically transformed tumors is also poorly understood. 12 , 13 In considerationofthe incidenceofrecurrent atypical meningiomas in clinical practice

retrospectively conducted by a neurosurgeon in a blinded fashion. Manual segmentation was performed with region-of-interest analysis to measure tumor volumes (in cubic centimeters) on the basisofcontrast-enhancing tissue seen on T1-weighted MR imaging.Extentofresectionwas calculated as follows: (preoperative tumor volume − postoperative tumor volume)/preoperative tumor volume. Determinationofvolumes was made without considerationofclinical outcome. Statistical Analysis Age, percent EOR, KPS scores, and tumor volumes were analyzed as continuous variables. To

overcome these limitations with their paper “An程度上ofresectionthreshold for newly diagnosed glioblastomas.” Their study is a single-institution, retrospective studyof500 patients without prior treatment for GBM. All patients received surgery at the UniversityofCalifornia, San Francisco, which was followed by standard chemotherapy and radiation. Characteristics by which the data were stratified included age, Karnofsky Performance Scale (KPS) score, sitesoftumor infiltration, eloquenceoftumor location, and程度上ofresection(EOR). No patients were lost to

more favorable long-term tumor control rates. 26 , 27 Also controversial is whether to resect or preserve the pituitary stalk, to what degree pituitary function can be preserved with this strategy, and whether preserving the stalk will impact long-term tumor control rates. 28 We performed a detailed analysisoffactors predictiveof程度上ofresectionand recurrence in a large cohortofcraniopharyngiomas removed via an EEA with long-term follow-up. We performed unsupervised hierarchical clustering analysis (HCA) to characterize the factors that determine outcome

including the intracanalicular portionofthe lesion. Tumor recurrence or progression was defined by the detectionof1ofthe following on follow-up imaging: 1) an increase in the sizeofresidual tumor by greater than or equal to 2 mm (in any dimension) between imaging studies, and/or 2) any new enhancement in the internal auditory canal or cerebellopontine angle cisternal space on follow-up imaging which was not present on initial postoperative imaging. The程度上ofresectionwas judged by subjective intraoperative impression; however, if the MR images obtained

extensiveresectionofthese lesions. However, the infiltrative natureof总remov肿瘤恶性星形细胞瘤中排除al. It therefore remains unclear whether more extensiveresectionofmalignant astrocytomas is associated with prolonged survival. We set out to determine if the程度上ofresectionwas associated with survival in our institutional experience with malignant astrocytomas. Methods We retrospectively identified all patients who had undergoneresectionofmalignant astrocytomas (WHO Grade III or IV) 22 at our academic institution from 1996

T he treatmentofpatients with high-grade gliomas remains a challenge for modern therapy. The prognosis for these patients is poor; the median patient survival after diagnosis is approximately 1 year. 36, 38 The need for a histological diagnosisoftumor tissue in each case and the importanceofdecompression in symptomatic patients are well established; however, there is still controversy regarding the程度上ofsurgicalresectionto be performed. Although many neurosurgeons recommend that gliomas be resected as extensively as possible, 26, 32 rigorous

radiation therapy with a total doseof54–60 Gy, and different protocolsofchemotherapy. 9 , 11 , 12 , 25 , 30 , 33 Many predictive factors have been considered in glioblastoma patients. Good neurological status,程度上ofresection, and young age have been reported to correlate with longer survival. 9 , 11 In particular, the importanceofthe程度上ofresectionas a prognostic factor has been demonstrated in several studies. 23 , 29 , 31 Oneofthe most important prognostic factors that is widely accepted is younger patient age. 16 However, the numberofelderly

+ irinotecan 3 (9) 4 (19) 7 (27) 3 (10) lomustine 0 (0) 0 (0) 0 (0) 2 (7) other 10 (32) 2 (10) 3 (11) 5 (17) * Values represent numbersofpatients (%) unless otherwise indicated. Abbreviation: Recur = Recurrence. The程度上ofresectionfor each procedure was retrospectively reviewed by a single, experienced neuroradiologist blinded to clinical information. Volumetric analysisofthe contrast-enhancing tumor calculated by the reviewing neuroradiologist was used to assess the EOR. T1-weighted pre- and postcontrast images from the