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Surgical management and outcome of primary intracranial Rosai-Dorfman disease: a single-institute experience and pooled analysis of individual patient data

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机构: [1]Shandong First Med Univ, Dept Neurosurg, Shandong Prov Hosp, Jinan, Peoples R China [2]German Canc Res Ctr, Div Mol Neurogenet, DKFZ ZMBH Alliance, Neuenheimer Feld 280, D-69120 Heidelberg, Germany [3]Univ Elect Sci & Technol China, Sichuan Canc Hosp, Head & Neck Surg Ctr, Sch Med, Chengdu, Peoples R China [4]Liao Cheng Third Peoples Hosp, Dept Radiol, Liaocheng, Peoples R China [5]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Nansihuanxilu 119, Beijing, Peoples R China
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关键词: Primary intracranial Rosai-Dorfman disease Radiotherapy Steroid therapy Surgical resection

摘要:
Primary intracranial Rosai-Dorfman disease (PIRDD) is considered a nonmalignant nonneoplastic entity, and the outcome is unclear due to its rarity. The study aimed to elaborate the clinic-radiological features, treatment strategies, and progression-free survival (PFS) in patients with PIRDD. Patients with pathologically confirmed PIRDD in our institute were reviewed. Literature of PIRDD, updated until December 2019, was systematically searched in 7 databases (Embase, PubMed, Cochrane database, Web of Science, Wanfang Data Knowledge Service Platform, the VIP Chinese Science and Technology Periodical Database (VIP), and the China National Knowledge Infrastructure (CNKI)). These prior publication data were processed and used according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Clinical-radiological characteristics and adverse factors for PFS were evaluated in the pooled cohort. The pooled cohort of 124 cases (81 male and 43 female), with a mean age of 39.7 years, included 11 cases from our cohort and 113 cases from 80 prior studies. Twenty-nine patients (23.4%) had multiple lesions. Seventy-four patients (59.7%) experienced gross total resection (GTR), 50 patients (40.3%) had non-GTR, 15 patients (12.1%) received postoperative adjuvant radiation, and 23 patients (18.5%) received postoperative steroids. A multivariate Cox regression revealed that GTR (HR = 4.52; 95% CI 1.21-16.86; p = 0.025) significantly improved PFS, and multiple lesions (p = 0.060) tended to increase the hazard of recurrence. Neither radiation (p = 0.258) nor steroids (p = 0.386) were associated with PFS. The overall PFS at 3, 5, and 10 years in the pooled cohort was 88.4%, 79.4%, and 70.6%, respectively. The PFS at 5 and 10 years in patients with GTR was 85.4% and 85.4%, respectively, which was 71.5% and 35.8%, respectively, in patients without GTR. Gross total resection significantly improved PFS and was recommended for PIRDD. Radiation and steroids were sometimes empirically administered for residual, multiple, or recurrent PIRDD, but the effectiveness remained arguable and required further investigation.Systematic review registration number: CRD42020151294.

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出版当年[2023]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 外科
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大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 外科
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出版当年[2023]版:
Q1 SURGERY Q2 CLINICAL NEUROLOGY
最新[2023]版:
Q1 SURGERY Q2 CLINICAL NEUROLOGY

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第一作者机构: [1]Shandong First Med Univ, Dept Neurosurg, Shandong Prov Hosp, Jinan, Peoples R China
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