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BackgroundMaintenance of postoperative long-term independence has value for older adults who undergo surgical procedures. However, independence has barely caught attention for the elderly with meningiomas. Preventing postoperative long-term independence decline in this population necessitates the identification of the factors related to this outcome and minimizing their implications. Therefore, we assessed the independence evolution and identified potential determinants and population.Materials and MethodsFrom 2010 to 2016, elderly meningioma patients (≥65 years old) undergoing operation at Beijing Tiantan Hospital were included in our study. The primary outcome was 3-year (i.e., long-term) postoperative independence measured by Karnofsky performance scale (KPS) score. We used univariate and multivariate analyses to determine the risk factors for postoperative long-term independence, and nomogram was established.ResultsA total of 470 patients were included eligibly. The distribution in each KPS was significantly different before and 3 years after resection (P < 0.001). Especially in patients with preoperative KPS 80 and 70, only 17.5 and 17.3% of the patients kept the same KPS after 3 years, and the remaining patients experienced significant polarization. The most common remaining symptom cluster correlated with postoperative long-term independence included fatigue (R = −0.795), memory impairment (R = −0.512), motor dysfunction (R = −0.636) and communication deficits (R = −0.501). Independent risk factors for postoperative long-term non-independence included: advanced age (70–74 vs. 65–69 OR: 2.631; 95% CI: 1.545–4.481 and ≥75 vs. 65–69 OR: 3.833; 95% CI: 1.667–8.812), recurrent meningioma (OR: 7.791; 95% CI: 3.202–18.954), location in the skull base (OR: 2.683; 95% CI: 1.383–5.205), tumor maximal diameter >6 cm (OR: 3.089; 95% CI: 1.471–6.488), nerves involved (OR: 3.144; 95% CI: 1.585–6.235), high risk of WHO grade and biological behavior (OR: 2.294; 95% CI: 1.193–4.408), recurrence during follow-up (OR: 10.296; 95% CI: 3.253–32.585), lower preoperative KPS (OR: 0.964; 95% CI: 0.938–0.991) and decreased KPS on discharge (OR: 0.967; 95% CI: 0.951–0.984) (P < 0.05). The discrimination and calibration of the nomogram revealed good predictive ability (C-index: 0.810).ConclusionElderly meningioma patients might present significant polarization trend in maintaining long-term independence after surgery. Our findings will be helpful for guiding surgical management for the elderly with meningioma and provide proposals for early functional rehabilitation.

OBJECTIVE: To characterize co-deletion of chromosome 1p/19q and IDH1/2 mutation in Chinese brain tumor patients and to assess their associations with clinical features. METHODS: In a series of 528 patients with gliomas, pathological and radiological materials were reviewed. Pathological constituents of tumor subsets, incidences of 1p/19q co-deletion and IDH1/2 mutation in gliomas by regions and sides in the brain were analyzed. RESULTS: Overall, 1p and 19q was detected in 339 patients by FISH method while the sequence of IDH1/2 was determined in 280 patients. Gliomas of frontal, temporal and insular origin had significantly different pathological constituents of tumor subsets (P

The article describes the case of a 52-year-old man who developed central nervous system histiocytic sarcoma (CNS HS). The patient presented with weakness of left lower limb of 15 days. CNS HS is a rare disease whose median survival is at approximately five months. Since most cases of CNS HS have a single lesion, the preferred initial therapy is surgery.

Glioblastoma multiforme (GBM) is the most common form of malignant glioma, characterized by genetic instability and unpredictable clinical behavior. GBM is marked by an extremely poor prognosis with median overall survival of 12~14 months. In this study, we detected the CD137L-expressing cells and IL-17-expressing cells in tumor tissues resected from patients with GBM. Expression of CD137L and IL-17 were assessed by immunohistochemistry, and the prognostic value of CD137L and IL-17 expression within the tumor tissues were assessed by Cox regression and Kaplan-Meier analysis. Immunohistochemical detection showed that positive cells of CD137L and IL-17 in glioblastoma tissue samples were 46.3% (19/ 41) and 73.2% (30/41) respectively. Expression of CD137L was not correlated with overall survival of GBM patients (P=0.594), while significantly longer survival rate was seen in patients with high expression of IL-17, compared to those with low expression of IL-17 (P=0.007). In addition, we also found that IL-17 expression was significantly correlated with Progression-free survival (PFS) (P=0.016) and death rate (P=0.01). Furthermore, multivariate Cox proportional hazard analyses revealed that IL-17 (P=0.018) and PFS (P=0.028) were independent factors affecting the overall survival probability. Kaplan-Meier analysis showed that PFS of high expression of IL-17 group were significantly longer (P=0.004) than low expression group with GBM. It is concluded that high levels of IL-17 expression in the tumor tissues may be a good prognostic marker for patients with GBM.

Objective: Intracranial schwannomas of the brain, which are unrelated to the cranial nerves, are extremely rare. In this article, we present a series of eighteen cases of intracranial intraparenchymal and intraventricular schwannomas, which is the largest series to date. Methods: During the 10-year period from January 2000 to October 2010, we encountered 2491 histologically established cases of intracranial schwannomas, of which only 18 were not related to the cranial nerves. Clinical profiles, radiological features, surgical procedures, intraoperative findings and outcomes were extracted from the patient records and neuroimaging data. Results: No patients were preoperatively diagnosed with schwannoma. The diagnosis of schwannoma was made by pathological examination with H&E staining and immunohistochemical examination. The 18 cases with intracranial ectopic schwannomas account for 0.8% of all the intracranial schwannomas that were observed within the same time period at our hospital. The age distribution of the patients ranged from 7 to 78 years. There was a slight male predominance: 11 male and 7 female patients (M:F = 1.6:1). Headaches were the most common presenting symptom and were found in most cases. Common neuroradiological characteristics included peritumoral edema and intralesional cysts. Conclusion: Intracranial intraparenchymal and intraventricular schwannomas are rare, benign neoplasms that cannot be preoperatively differentiated from other parenchymal tumors. Surgical excision is curative, and the long-term prognosis is good. Additional studies are needed to confirm the histogenesis of this schwannoma type. [ABSTRACT FROM AUTHOR]