Save
Transsylvian surgery of the insular glial tumors
EANS Academy. Bykanov A. 09/26/19; 276004; EP03063
Dr. Andrey Bykanov
Dr. Andrey Bykanov

Access to this content is reserved for EANS members and attendees of this event. Click here to become an EANS member and gain your access to the full content of the EANS Academy


Abstract
Discussion Forum (0)
Rate & Comment (0)
Objective: Insular glial tumors remain a challenge for surgery due to their complex anatomy. Transsylvian approach persists the primary approach for reaching the insular lobe.
Methods: From 2012 to 2017, 79 consecutive patients underwent tumor resection through transsylvian approach. Postsurgical neurological outcomes, survival and predictability of our and Berger-Sanai zone classifications systems were investigated using univariate and multivariate analyzes.
Results: The median extent of resection was 86.5 %. Postoperative transient neurological deficit was recorded in 31 (39.2%) patients, and permanent in 5 (6.3%) patients.
Significant predictors of overall survival on univariate analysis were KPS, the presence of IDH1 mutation, history of seizures, tumor Grade, and EOR ( p < 0.05). On multivariate analysis IDH1 mutation (p = 0.03, HR = 0.202) and tumors grade (p = 0.002, HR = 0.037) were independent predictors of survival. Significant predictors of progression free survival on univariate analysis for all grades were age, the IDH1 mutation presence , Grade of tumor, and EOR ( p < 0.05); on multivariate analysis IDH1 mutation presents (p = 0.016, HR = 0.362), Grade of tumor (p = 0.0001, HR = 0.068) and the EOR (p = 0.0001, HR = 0.951). The tumor volume, the EOR and the incidence of permanent neurological deficit ( p < 0.05) were correlated with the group the patients according to our classification. The lowest EOR and the highest rate of residual tumors were in Zone II ( p < 0.05) according to the Berger-Sinai tumor classification.
Conclusion: our classification of brain insular tumors enables a preoperative prediction for the degree of tumor resection and the occurrence of persistent neurological deficit. According to the Berger-Sinai tumor classification Zone II is associated with a low degree of resection of insular tumors through transsilvian approach.
Objective: Insular glial tumors remain a challenge for surgery due to their complex anatomy. Transsylvian approach persists the primary approach for reaching the insular lobe.
Methods: From 2012 to 2017, 79 consecutive patients underwent tumor resection through transsylvian approach. Postsurgical neurological outcomes, survival and predictability of our and Berger-Sanai zone classifications systems were investigated using univariate and multivariate analyzes.
Results: The median extent of resection was 86.5 %. Postoperative transient neurological deficit was recorded in 31 (39.2%) patients, and permanent in 5 (6.3%) patients.
Significant predictors of overall survival on univariate analysis were KPS, the presence of IDH1 mutation, history of seizures, tumor Grade, and EOR ( p < 0.05). On multivariate analysis IDH1 mutation (p = 0.03, HR = 0.202) and tumors grade (p = 0.002, HR = 0.037) were independent predictors of survival. Significant predictors of progression free survival on univariate analysis for all grades were age, the IDH1 mutation presence , Grade of tumor, and EOR ( p < 0.05); on multivariate analysis IDH1 mutation presents (p = 0.016, HR = 0.362), Grade of tumor (p = 0.0001, HR = 0.068) and the EOR (p = 0.0001, HR = 0.951). The tumor volume, the EOR and the incidence of permanent neurological deficit ( p < 0.05) were correlated with the group the patients according to our classification. The lowest EOR and the highest rate of residual tumors were in Zone II ( p < 0.05) according to the Berger-Sinai tumor classification.
Conclusion: our classification of brain insular tumors enables a preoperative prediction for the degree of tumor resection and the occurrence of persistent neurological deficit. According to the Berger-Sinai tumor classification Zone II is associated with a low degree of resection of insular tumors through transsilvian approach.
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings