Microsurgical Outcomes and Prognostic Analysis of 450 Cases of Cerebellar Gliomas: Integrating Pathology, Molecular Biomarkers, and Novel Clinical Insights
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 450
- 试验地点
- 1
- 主要终点
- Overall survival (OS) time
研究概览
简要总结
The goal of this observational study is to learn if refined anatomical location-combined with molecular biomarkers-can predict surgical success and long-term survival in 450 adults and children with cerebellar gliomas who underwent microsurgical resection at a single center between 2014 and 2024. The main questions it aims to answer are:
- Does tumor location (cerebellar hemisphere, vermis, fourth ventricle, or pontocerebellar-angle region) independently influence extent of resection and overall survival after adjustment for WHO grade and molecular profile?
- Among IDH-wild-type low-grade gliomas, does gross-total resection plus early adjuvant radiotherapy improve 5-year overall and progression-free survival compared with lesser resection or radiotherapy omission?
Researchers compared four anatomical subgroups and multiple molecular subtypes (IDH, 1p/19q, MGMT, TERT, BRAF V600E) to quantify location-specific resection rates, complication rates, and survival outcomes. Participants underwent standardized pre-operative imaging, microsurgical resection with intra-operative monitoring when indicated, post-operative MRI within 48 h to quantify residual tumor, and longitudinal clinical and radiographic follow-up every 3-12 months for up to 10 years.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 3 Years 至 80 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Pathologically proven cerebellar glioma (hemisphere, vermis, fourth ventricle, or pontocerebellar-angle region) per 2021 WHO CNS classification
- •First microsurgical resection performed at our center between January 2014 and January 2024
- •Age ≥ 3 years at surgery
- •Pre-operative Karnofsky Performance Status (KPS) recorded
- •Availability of post-operative contrast MRI for resection-extent calculation
- •Minimum required molecular data: IDH1/2 status (immunohistochemistry ± sequencing)
- •Continuous follow-up ≥ 6 months after surgery (out-patient visits or telephone confirmation)
排除标准
- •Brain-stem glioma with secondary cerebellar invasion
- •Recurrent or metastatic glioma
- •Previous cranial radiation or glioma surgery at another institution
- •Palliative resection (< 20 % of tumor volume removed)
- •Missing post-operative MRI or insufficient tissue for mandatory IDH testing
- •Follow-up < 6 months or lost to follow-up before 6-month landmark
研究组 & 干预措施
Cerebellar hemisphere
Tumors arise from Cerebellar hemisphere
Vermis
Tumors arise from Cerebellar Vermis
Fourth ventricle
Tumors arise from Fourth ventricle
Pontocerebellar-angle (PCA) region
tumors from Pontocerebellar-angle (PCA) region
结局指标
主要结局
Overall survival (OS) time
时间窗: 6 months
the number of months from the date of microsurgical resection to the date of death from any cause or last confirmed follow-up, measured for all 450 enrolled patients and compared across the four anatomical cerebellar locations and the predefined molecular sub-groups.
次要结局
- Progression-Free Survival (PFS)(6 months)
- Extent of Resection (EOR)(6 months)
- Rate of Postoperative Complications(6 months)
研究者
Zhigang Lan
Professor
West China Hospital