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61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010
Joint Meeting mit der Brasilianischen Gesellschaft für Neurochirurgie am 20. September 2010

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21. - 25.09.2010, Mannheim

Resection of gliomas in the cingulate gyrus – functional outcome and survival

Meeting Abstract

  • Ági Oszvald - Klinik für Neurochirurgie, Goethe-Universität Frankfurt am Main, Deutschland
  • Valeri Borger - Klinik für Neurochirurgie, Goethe-Universität Frankfurt am Main, Deutschland
  • Kea Franz - Klinik für Neurochirurgie, Goethe-Universität Frankfurt am Main, Deutschland
  • Erdem Güresir - Klinik für Neurochirurgie, Goethe-Universität Frankfurt am Main, Deutschland
  • Hartmut Vatter - Klinik für Neurochirurgie, Goethe-Universität Frankfurt am Main, Deutschland
  • Volker Seifert - Klinik für Neurochirurgie, Goethe-Universität Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1562

DOI: 10.3205/10dgnc038, URN: urn:nbn:de:0183-10dgnc0387

Veröffentlicht: 16. September 2010

© 2010 Oszvald et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: In this study the aim was to evaluate the feasibility of surgical treatment in patients with gliomas involving the cingulate gyrus as part of the limbic system in a series of 47 cases. These tumors often reach and affect the corpus callosum and the central region making operative treatment complicated.

Methods: We analyzed preoperative data, surgical treatment, functional outcome and survival of 47 patients (f:m; 23/24) with gliomas arising from the cingulate gyrus with a mean age of 45 years (±14 y). The data was entered in a prospectively conducted database of gliomas between June 1999 and January 2010. The cingulate gyrus was divided by the central sulcus into an anterior and posterior part. The extent of resection was based on the early postoperative MRI and labeled as complete, subtotal (<5% residual tumor) and partial (>5% residual tumor).

Results: The majority (85%) of the gliomas were located in the anterior part of the cingulate gyrus and 15% in the posterior part. Seizures were the dominant presenting symptom in 25 patients (53%). 7 patients (15%) presented with hemiparesis. The mean preoperative Karnofsky index was 90 (SD±16, range 40–100) and the mean preoperative NIHSS Score was 1 (SD±1.6, range 0–5). Histopathological examination showed a WHO grade II tumor in 9 patients (19%), a WHO grade III tumor in 13 patients (28%) and a glioblastoma in 25 patients (53%). In 26 (55%) patients complete resection, in 16 (34%) patients subtotal resection and in 5 (11%) patients partial resections was achieved. 7 (15%) patients showed a SMA lesion and 4 (11%) patients had new or worsened hemiparesis postoperatively. The early postoperative NIHSS score (2–5 days) was 2 (SD±1.4, range 0–5) and the late postoperative NIHSS score (30 days) was 0 (SD±1.2, range 0–6; p<0.001). Up to today 20/47 patients died (3 grade II, 1 grade III, 16 grade IV). The mean survival time of all patients including the living is 56 (±62) month in grade II, 59 (±58) month in grade III and 13 (±18) month in grade IV.

Conclusions: Microsurgical resection of gliomas arising from the cingulate gyrus is feasible, even complete resection can be achieved in many tumors arising from the cingulate gyrus. Functional outcome of the patients is good, even though some patients experience transient deficits