| Popis: |
For 100 operated patients with malignant gliomas of the brain (63 malignant gliomas WHO grade IV--including 50 glioblastoma multiforme- and 37 astrocytomas WHO grade III-IV) the average survival time is 332 days. The survival rates show 6, 12 and 24 months after operation 55%, 32% and 12% of the patients alive. In addition to therapy there are some favourable prognostic factors: Young patients age at the onset of illness, localization in the non-dominant hemisphere, minor preoperative neurological deficit. On the other side unfavourable prognostic factors are: parietal localization (average survival time = 120 days), tumorous infiltration of the brain stem (average survival time = 143 days), preoperative clouding of consciousness (average survival time = 185 days). These factors influence survival time. The most important prognostic factor of therapy is the extent of operation: In case of macroscopical total resection of the tumor the mean survival time amounts to 554 days as compared to 202 days in subtotal tumor resection. The well known positive influence of postoperative radiation therapy is demonstrated by the high mean survival time of 456 days. In case of recurrent operation of the tumor (28 patients), the average survival time amounts to 443 days. In contrast to the literature our own analysis shows no prognostic value of histological variants in case of malignant glioma WHO grade IV. Two patients, whose histological slide preparations were neuropathologically graded a second time independent from the first view (1 anaplastic ependymoma WHO grade III and 1 glioblastoma multiforme WHO grade IV), are still alive more than 8 years after operation without any neurological deficit. |
