Document Detail


Combination of microsurgery and Gamma Knife surgery for the treatment of intracranial chondrosarcomas.
MedLine Citation:
PMID:  18503325     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Intracranial chondrosarcomas have a high risk of recurrence after surgery. This retrospective study of patients with intracranial chondrosarcoma was conducted to determine the long-term results of microsurgery followed by Gamma Knife surgery (GKS) for residual tumor or recurrence. METHODS: The authors treated nine patients whose median age was 36 years. Seven patients had low-grade chondrosarcomas (LGCSs), whereas mesenchymal chondrosarcomas (MCSs) were diagnosed in two. Radiosurgery was performed in eight patients, whereas one patient declined further surgical intervention and tumor-volume reduction necessary for the GKS. The patients were followed up for 15 to 173 months (median 108 months) after diagnosis and 3 to 166 months (median 88 months) after GKS. Seven patients had residual tumor tissue after microsurgery, and two operations appeared radical. In the two latter cases, tumors recurred after 25 and 45 months. Thus, definite tumor control was not achieved after surgery alone in any patient, whereas the addition of radiosurgery allowed tumor control in all six patients with LGCSs. Two of these patients experienced an initial tumor regrowth after GKS; in both cases the recurrences were outside the prescribed radiation field. The patients underwent repeated GKS, and subsequent tumor control was observed. An MCS was diagnosed in the remaining two patients. Complications after microsurgery included diplopia, facial numbness, and paresis. After GKS, one patient had radiation necrosis, which required microsurgery, and two patients had new cranial nerve palsies. CONCLUSIONS: Tumor control after microsurgery alone was not achieved in any patient, whereas adjuvant radiosurgery provided local tumor control in six of eight GKS-treated patients. Tumor control was not achieved in the two patients with MCS. Similar to other treatments for intracranial chondrosarcoma, morbidity after micro- and radiosurgical combination therapy was high and included severe cranial nerve palsies.
Authors:
Petter Förander; Tiit Rähn; Lars Kihlström; Elfar Ulfarsson; Tiit Mathiesen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  105 Suppl     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2008-05-27     Completed Date:  2009-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  18-25     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Karolinska Universitets Sjukhuset, Stockholm, Sweden. petter.forander@karolinska.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Chondrosarcoma / mortality,  pathology,  surgery*
Cohort Studies
Combined Modality Therapy
Disease-Free Survival
Female
Humans
Male
Microsurgery*
Middle Aged
Radiosurgery*
Retrospective Studies
Skull Base Neoplasms / mortality,  pathology,  surgery*
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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