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Meningiomas: đáy sọ so với không phải đáy sọ
Tóm tắt
Để xác định sự khác biệt giữa u màng não tại đáy sọ (SBM) và u màng não không tại đáy sọ (NSBM). Tất cả bệnh nhân trưởng thành (18.0–69.9 tuổi) được phẫu thuật điều trị u màng não trong sọ giữa năm 1990 và 2010 tại cơ sở của chúng tôi đã được nghiên cứu. Định nghĩa của Al-Mefty đã được sử dụng để phân chia các khối u thành SBM và NSBM. Tổng cộng, 1148 bệnh nhân liên tiếp đã được xác định. Tuổi trung bình tại thời điểm phẫu thuật là 54.2 năm [18.1–69.9]. Thời gian theo dõi trung bình là 7.4 năm [0.0–20.9]. Có 562 bệnh nhân (49%) mắc SBM và 586 (51%) mắc NSBM. Hai nhóm này tương tự nhau về độ tuổi bệnh nhân, thời gian theo dõi và số lượng bệnh nhân. Tỷ lệ nữ so với nam tổng thể là 2.6:1, nhưng 3.2:1 trong SBM và 2.2:1 trong NSBM (p < 0.005). Về các triệu chứng xuất hiện, các khối u SBM có thường xuyên hơn các rối loạn thần kinh (tỷ lệ rủi ro (RR) 1.4; p < 0.0001) và ít thường xuyên hơn các cơn động kinh (RR 0.4; p < 0.0001). Mổ cắt toàn bộ khối u (Gross total resections) ít xảy ra hơn ở SBM so với NSBM (62% so với 84%) (RR 1.3; p < 0.0001). SBM có nguy cơ thấp hơn về tế bào học WHO cấp II và III (4.5% so với 9.5%) (RR 0.5; p < 0.001). Sự suy giảm chức năng thần kinh thường gặp hơn ở SBM (21% so với 121%) (RR 1.8; p < 0.001). Tỷ lệ sống sót không tái điều trị trong 5, 10 và 15 năm, tương ứng, là 80%, 70% và 62% với SBM so với 90%, 82% và 74% với NSBM (p < 0.0001). Tỷ lệ sống sót tổng thể trong 5, 10 và 15 năm, tương ứng, là 93%, 85% và 78% cho SBM và 96%, 91% và 79% cho NSBM (p = 0.14). Bệnh nhân mắc SBM có nhiều triệu chứng thần kinh mới khởi phát hơn và thời gian sống không tái điều trị ngắn hơn đáng kể, nhưng điều này không ảnh hưởng xấu đến tỷ lệ sống tổng thể.
Từ khóa
#u màng não; đáy sọ; tỷ lệ sống; triệu chứng thần kinhTài liệu tham khảo
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