Accuracy and safety of 101 consecutives neurosurgical procedures for newly diagnosed central nervous system lymphomas: a single-institution experience.

Adult Aged Brain Neoplasms Central Nervous System Hematologic Neoplasms Humans Lymphoma Neurosurgical Procedures Retrospective Studies Treatment Outcome
Biopsy Efficacy Lymphoma Safety Steroid Surgery

Journal

Journal of neuro-oncology
ISSN: 1573-7373
Titre abrégé: J Neurooncol
Pays: United States
ID NLM: 8309335

Informations de publication

Date de publication:
Sep 2022
Historique:
received: 04 05 2022
accepted: 13 06 2022
pubmed: 28 6 2022
medline: 31 8 2022
entrez: 27 6 2022
Statut: ppublish

Résumé

Brain surgery is required to ascertain the diagnosis of central nervous system lymphoma. We assessed the diagnostic yield and safety of the surgical procedures, the predictors of postoperative morbidity, and of overall survival. Observational single-institution retrospective cohort study (1992-2020) of 101 consecutive adult patients who underwent stereotactic biopsy, open biopsy, or resection for a newly diagnosed central nervous system lymphoma. The diagnostic yield was 100% despite preoperative steroid administration in 48/101 cases (47.5%). A preoperative Karnofsky Performance Status score less than 70 (p = 0.006) was an independent predictor of a new postoperative focal neurological deficit (7/101 cases, 6.9%). A previous history of hematological malignancy (p = 0.049), age 65 years or more (p = 0.031), and new postoperative neurological deficit (p < 0.001) were independent predictors of a Karnofsky Performance Status score decrease 20 points or more postoperatively (13/101 cases, 12.9%). A previous history of hematological malignancy (p = 0.034), and preoperative Karnofsky Performance Status score less than 70 (p = 0.024) were independent predictors of postoperative hemorrhage (13/101 cases, 12.9%). A preoperative Karnofsky Performance Status score less than 70 (p = 0.019), and a previous history of hematological malignancy (p = 0.014) were independent predictors of death during hospital stay (8/101 cases, 7.9%). In the 82 immunocompetent patients harboring a primary central nervous system lymphoma, age 65 years or more (p = 0.044), and time to hematological treatment more than 21 days (p = 0.008), were independent predictors of a shorter overall survival. A dedicated hematological treatment (p < 0.001) was an independent predictor of a longer overall survival. Brain biopsy is feasible with low morbidity for central nervous system lymphomas. Postoperatively, patients should be promptly referred for hematological treatment initiation.

Identifiants

DOI: 10.1007/s11060-022-04069-6 PMID: 35759152
pubmed: 35759152
doi: 10.1007/s11060-022-04069-6
pii: 10.1007/s11060-022-04069-6
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

347-358

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Ilyes Aliouat (I)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France.
Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France.

Alessandro Moiraghi (A)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France.
Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France.

Giorgia Antonia Simboli (GA)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France.
Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France.

Rudy Birsen (R)

Hematology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Angela Elia (A)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France.
Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France.
Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Alexandre Roux (A)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France.
Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France.

Jérôme Tamburini (J)

Hematology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Edouard Dezamis (E)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France.

Eduardo Parraga (E)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France.

Chiara Benevello (C)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France.
Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France.

Diane Damotte (D)

Pathology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Corentin Provost (C)

Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France.
Department of Neuroradiology, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 75014, Paris, France.

Catherine Oppenheim (C)

Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France.
Department of Neuroradiology, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 75014, Paris, France.

Didier Bouscary (D)

Hematology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Fabrice Chretien (F)

Department of Neuropathology, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 75014, Paris, France.

Marc Zanello (M)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France.
Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France.

Johan Pallud (J)

Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 1 rue Cabanis, 75014, Paris Cedex 14, France. johanpallud@hotmail.com.
Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, F-75014, Paris, France. johanpallud@hotmail.com.

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Classifications MeSH

Recherchemedicale.com › Personnes › Tranches d'âge › Adulte › Accuracy and safety of 101 consecutives...
Recherchemedicale.com › Personnes › Tranches d'âge › Adulte › Sujet âgé › Accuracy and safety of 101 consecutives...
Recherchemedicale.com › Maladies du système nerveux › Tumeurs du système nerveux › Tumeurs du système nerveux central › Tumeurs du cerveau › Accuracy and safety of 101 consecutives...
Recherchemedicale.com › Système nerveux › Système nerveux central › Accuracy and safety of 101 consecutives...
Recherchemedicale.com › Hémopathies et maladies lymphatiques › Hémopathies › Tumeurs hématologiques › Accuracy and safety of 101 consecutives...
Recherchemedicale.com › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Accuracy and safety of 101 consecutives...
Recherchemedicale.com › Maladies du système immunitaire › Syndromes immunoprolifératifs › Syndromes lymphoprolifératifs › Lymphomes › Accuracy and safety of 101 consecutives...
Recherchemedicale.com › Procédures de chirurgie opératoire › Procédures de neurochirurgie › Accuracy and safety of 101 consecutives...
Recherchemedicale.com › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Accuracy and safety of 101 consecutives...
Recherchemedicale.com › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Accuracy and safety of 101 consecutives...