Turkish Neurosurgery
ADULT BRAINSTEM GLIOMAS - RETROSPECTIVE ANALYSIS OF 51 PATIENTS
Goran Tasic2, Nikola Repac1, Igor Nikolic2, Vojislav Bogosavljevic2, Vul Scepanovic1, Aleksandar Janicijevic1, Aleksandra Eric-Nikolic3, Lukas Rasulic2
1Clinic for Neurosurgery, CLinical Center of Serbia, Belgrade,
2Medical Faculty, Univeristy of Belgrade, Belgrade,
3National Cancer Research Center, Belgrade,
DOI: 10.5137/1019-5149.JTN.16488-15.1
Aim:Brain stem gliomas constitute less than 2% of brain tumors in adults. Therapeutic options are limited and brainstem gliomas are associated with a high morbidity and mortality.Material and Methods:We reviewed the records of 51 patients with brainstem gliomas treated at the Institute of Neurosurgery, Clinical Center of Serbia in Belgrade between 1998 and 2012. We recorded demographic and clinical variables as well as radiological findings and survival.Results:Of the 51 patients 62.7% were male and 37.3% female, mean age 30.6 ± 19.3 years. At the age 38.2 ± 17.9 years dominated the high grade type of glioma (As. Gr. III and IV) - t = 2.481, p = 0.017. While histological type As. gr. I-II dominant in the younger age 25.4 ± 17.4 years - X2 = 4.013; p = 0.045, with localization in the pons - X2 = 5.299; p = 0.021 and present exophytic component - X2 = 3.862; p = 0.049. Ataxia as initial symptom is a predictor of poor outcome - HR 5.546; p = 0.012.Conclusion:Due to its specific localization brain stem gliomas (BSG) today present a major challenge for neurosurgery, because of need for safe approach due to radical resection. Histological verification BSG determines the need for additional therapeutic procedures - radiation and chemotherapy. Benefit from correct diagnosis is reflected in the avoidance of potentially adverse effects of treatment.
Corresponding author : Lukas Rasulic