Asian Pacific Journal of Cancer Prevention

  • 제14권9호
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  • Pages.5179-5183
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  • 2013
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  • 1513-7368(pISSN)
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  • 2476-762X(eISSN)
아시아태평양암예방학회 (Asian Pacific Journal of Cancer Prevention)
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Clinical Effectiveness of Preoperative Embolization for Cerebellar Hemangioblastoma

  • Liu, Ai-Hua (Department of Interventional Neuroradiology, Beijing Neurosurgical Institute) ;
  • Peng, Tang-Ming (Department of Interventional Neuroradiology, Beijing Neurosurgical Institute) ;
  • Wu, Zhen (Department of neurosurgery, Beijing Tiantan Hospital, Capital Medical University) ;
  • Xiao, Xin-Ru (Department of neurosurgery, Beijing Tiantan Hospital, Capital Medical University) ;
  • Jiang, Chu-Han (Department of Interventional Neuroradiology, Beijing Neurosurgical Institute) ;
  • Wu, Zhong-Xue (Department of Interventional Neuroradiology, Beijing Neurosurgical Institute) ;
  • Li, You-Xiang (Department of Interventional Neuroradiology, Beijing Neurosurgical Institute)
  • 발행 : 2013.09.30
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초록

The cerebellar hemangioblastoma (CHB) has an abundant blood supply and deep anatomical location. Complete surgical resection is generally very difficult. This study investigated the safety and effectiveness of preoperative embolization followed by surgical resection of CHB in a large cohort of patients. A database of 125 CHB patients with surgical resection in Beijing Tiantan Hospital between July 2006 and July 2012 was reviewed. Of those, 46 cases (experimental group) received preoperative embolization, 79 cases (control group) underwent surgery without embolization. Patient demographics, tumor size, duration of surgery, blood loss, blood transfusion, complications and follow-up results were collected and analyzed retrospectively. In the experimental group, the Kamofsky score (KS) was 80-100 in 40 cases (86.9%), 40-70 in 4 cases (8.7%), and below 40 in 2 cases (4.3%). Among 31 cases with follow-up, KS was 80-100 in 27 cases (87.1%), 40-70 in 2 cases (6.5%), and 0 in 2 cases (6.5%). In control group, KS was 80 -100 in 65 cases (82.2%), 40-70 in 6 cases (7.6%), 10-30 in 3 cases (3.8%), and 0 in 3 cases (3.8%). Among 53 cases with follow-up, KS was 80-100 in 44 cases (83.0%), 40-70 in 4 cases (7.5%), 10-30 in 1 case (1.9%), and 0 in 4 cases (7.5%). There were statistically significant differences between the experimental and control groups in tumor size, duration of surgery, amount of intraoperative blood loss and transfusion (p<0.01). However, complications (p=0.31) and follow-up results (p=0.76) showed no significant differences between groups. Selective preoperative embolization of those CHB patients with richer blood supply, higher hemorrhage risk, is safe and effective, and is a reliable adjuvant therapy for complete surgical resection of CHB.

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참고문헌

  1. Agrawal A, Kakani A, Vagh SJ, et al (2010). Cystic hemangioblastoma of the brainstem. J Neurosci Rural Pract, 1, 20-2. https://doi.org/10.4103/0976-3147.63096
  2. Browne TR, Adams RD, Roberson GH (1976). Hemangioblastoma of the spinal cord. Review and report of five cases. Arch Neurol, 33, 435-41. https://doi.org/10.1001/archneur.1976.00500060041009
  3. Chun YI, Cho J, Moon CT, Koh YC (2010). Delayed fatal cerebellar hemorrhage caused by hemangioblastoma after successful radiosurgical treatment. Acta Neurochir (Wien), 152, 1625-7; discussion 27. https://doi.org/10.1007/s00701-010-0669-7
  4. Cornelius JF, Saint-Maurice JP, Bresson D, et al (2007). Hemorrhage after particle embolization of hemangioblastomas: comparison of outcomes in spinal and cerebellar lesions. J Neurosurg, 106, 994-8. https://doi.org/10.3171/jns.2007.106.6.994
  5. Djindjian M (1986). Successful removal of a brainstem hemangioblastoma. Surg Neurol, 25, 97-100. https://doi.org/10.1016/0090-3019(86)90125-4
  6. Ellis JA, D'Amico R, Sisti MB, et al (2011). Pre-operative intracranial meningioma embolization. Expert Rev Neurother, 11, 545-56. https://doi.org/10.1586/ern.11.29
  7. Horvathy DB, Hauck EF, Ogilvy CS, et al (2011). Complete preoperative embolization of hemangioblastoma vessels with Onyx 18. J Clin Neurosci, 18, 401-3. https://doi.org/10.1016/j.jocn.2010.06.016
  8. Hussein MR (2007). Central nervous system capillary haemangioblastoma: the pathologist's viewpoint. Int J Exp Pathol, 88, 311-24. https://doi.org/10.1111/j.1365-2613.2007.00535.x
  9. Krishnan KG, Schackert G (2006). Outcomes of surgical resection of large solitary hemangioblastomas of the craniocervical junction with limitations in preoperative angiographic intervention: report of three cases. Zentralbl Neurochir, 67, 137-43. https://doi.org/10.1055/s-2006-933360
  10. Latorzeff I, Schlienger M, Sabatier J, et al (2012). [Radiosurgery for brain arteriovenous malformations]. Cancer Radiother, 16, S46-56. https://doi.org/10.1016/j.canrad.2012.05.003
  11. Montano N, Doglietto F, Pedicelli A, et al (2008). Embolization of hemangioblastomas. J Neurosurg, 108, 1063-4; author reply 64-5. https://doi.org/10.3171/JNS/2008/108/5/1063
  12. Munyon C, Chowdhry SA, Cohen ML, et al (2011). N-butyl 2-cyanoacrylate (n-BCA) embolization of a cerebellar hemangioblastoma. J Neurointerv Surg, 3, 386-9. https://doi.org/10.1136/jnis.2010.004366
  13. Murai Y, Kominami S, Yoshida Y, et al (2012). Preoperative liquid embolization of cerebeller hemangioblastomas using N-butyl cyanoacrylate. Neuroradiology, 54, 981-8. https://doi.org/10.1007/s00234-011-0985-5
  14. Ogiwara H, Ichi S, Ueki K, Suzuki I (2003). Cerebellar hemangioblastoma associated with primary hyperparathyroidism--case report. Neurol Med Chir (Tokyo), 43, 92-4. https://doi.org/10.2176/nmc.43.92
  15. Pereda Rios A, Pintado Recarte P, De Leon-Luis J, et al (2012). Cerebellar hemangioblastoma as the cause of maternal obstructive hydrocephalus during the third trimester. Eur J Obstet Gynecol Reprod Biol, 165, 370-2.
  16. Sakamoto N, Ishikawa E, Nakai Y, et al (2012). Preoperative endovascular embolization for hemangioblastoma in the posterior fossa. Neurol Med Chir (Tokyo), 52, 878-84. https://doi.org/10.2176/nmc.52.878
  17. Sorimachi T, Koike T, Takeuchi S, et al (1999). Embolization of cerebral arteriovenous malformations achieved with polyvinyl alcohol particles: angiographic reappearance and complications. AJNR Am J Neuroradiol, 20, 1323-8.
  18. Standard SC, Ahuja A, Livingston K, et al (1994). Endovascular embolization and surgical excision for the treatment of cerebellar and brain stem hemangioblastomas. Surg Neurol, 41, 405-10. https://doi.org/10.1016/0090-3019(94)90035-3
  19. Wang HH, Luo CB, Guo WY, et al (2013). Preoperative embolization of hypervascular pediatric brain tumors: evaluation of technical safety and outcome. Childs Nerv Syst.
  20. Zywicke H, Palmer CA, Vaphiades MS, Riley KO (2012). Optic nerve hemangioblastoma: a case report. Case Rep Pathol, 2012, 915408.

피인용 문헌

  1. The value of preoperative embolization in large and giant solid cerebellar hemangioblastomas vol.22, pp.4, 2016, https://doi.org/10.1177/1591019916633244
  2. Usefulness of Preoperative Transarterial Feeder Embolization of Cerebellar Hemangioblastomas pp.2186-2494, 2018, https://doi.org/10.5797/jnet.oa.2018-0021
  3. Indications for the Performance of Intracranial Endovascular Neurointerventional Procedures: A Scientific Statement From the American Heart Association vol.137, pp.21, 2018, https://doi.org/10.1161/CIR.0000000000000567