gms | German Medical Science

71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Article

Send article

Diagnostic yield of biopsy in corticosteroid pretreated patients with primary central nervous system lymphoma

Einfluss von präoperativem Kortison auf die Diagnoserate bei primären ZNS Lymphomen

Meeting Abstract

Search Medline for

  • presenting/speaker Florian Scheichel - Universitätsklinikum Sankt Pölten, Neurochirurgie, St. Pölten, Austria
  • Daniel Pinggera - Medizinische Universität Innsbruck, Neurochirurgie, Innsbruck, Austria
  • Barbara Kiesel - Medizinische Universität Innsbruck, Neurochirurgie, Wien, Austria
  • Tobias Rossmann - Sozialmedizinisches Zentrum Ost - Donauspital, Neurochirurgie, Wien, Austria
  • Branko Popadic - Universitätsklinikum Sankt Pölten, Neurochirurgie, St. Pölten, Austria
  • Michael Weber - Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Forschungsmanagement, Krems, Austria
  • Melitta Kitzwögerer - Universitätsklinikum Sankt Pölten, Pathologie, St. Pölten, Austria
  • Klaus Geissler - Sigmund Freud Privatuniversität, Wien, Austria
  • Astrid Dopita - Sozialmedizinisches Zentrum Ost - Donauspital, Pathologie und Mikrobiologie, Wien, Austria
  • Stefan Oberndorfer - Universitätsklinikum Sankt Pölten, Neurologie, St. Pölten, Austria
  • Christian F. Freyschlag - Medizinische Universität Innsbruck, Neurochirurgie, Innsbruck, Austria
  • Georg Widhalm - Medizinische Universität Innsbruck, Neurochirurgie, Wien, Austria
  • Karl Ungersböck - Universitätsklinikum Sankt Pölten, Neurochirurgie, St. Pölten, Austria
  • Franz Marhold - Universitätsklinikum Sankt Pölten, Neurochirurgie, St. Pölten, Austria

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV265

doi: 10.3205/20dgnc261, urn:nbn:de:0183-20dgnc2618

Published: June 26, 2020

© 2020 Scheichel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Corticosteroid treatment (CST) prior to biopsy may hinder histopathological diagnosis in primary central nervous system lymphoma (PCNSL). Therefore, preoperative CST in patients with suspected PCNSL should be strictly avoided if clinically possible. The aim of this study was to analyze the difference in thediagnostic yield of PCNSL patients with and without preoperative CST.

Methods: A retrospective study including all immunocompetent patients diagnosed with an intracranial PCNSL between 1/2004 and 9/2018 at four specialized neurosurgical centers in Austria, was conducted. Diagnostic yield was defined assuccessful diagnosis of PCNSL without the need for repeat biopsy.

Results: A total of 143 patients could be included in this study.There was no statistically significant difference inthe diagnostic yield of biopsy in patients with and without preoperative CST with 95.7% (67/70) and 97.3% (71/73) respectively (p=0.676). Preoperative tapering and pause of CST led tosignificant delay of the mediantimespan from first consultation to surgery with 18days in patientswithout CST or ongoing CST to 24days in patients with paused CST (p=0.023). Time to surgery over 45 days showed significant decrease of overall survival in multivariate regression.

Conclusion: No statistically significant difference inthe diagnostic yield of biopsy in PCNSL patients with and without preoperative CST was found. Tapering and pause of preoperative CST led tosignificant delay of surgery andsubsequently diagnosis and therapy which might result inworse outcome.In our opinion, surgeonstherefore should try to keep the diagnostic delay to a minimum as the diagnostic yield still seems to be sufficiently high in patients with preoperative CST.