Tumors of the Thalamus: Results of Surgical Treatment

Sh.U. Kadirov, A.N. Konovalov

Burdenko Research Institute of Neurosurgery, Moscow, Russia

 

There were 81 cases (children and adults) with tumors of the thalamus, operated at the Research Institute Neurosurgery in 1985-2005. The total number of operations was 96. Astrocytomas (grade I, II, III, IV) were the main histological type of tumors (87.5%). The rest tumors (12.5%) had another histological origin. Pilocytic astrocytomas (PA), astrocytomas (A), anaplastic astrocytomas (AA) were more frequent in children (p<0.05). Glioblastomas (GB) were predominant in adults (p<0.05). Total, subtotal and partial removal was performed in 40, 38 and 16 cases, respectively. Radical removal was most common in PA, AA and neoplasms of another histological origin (>50%). Subtotal and partial removal dominated in GB (50% and 20%, respectively) and A (42.86% and 23.81%, respectively).

Postoperative dynamics of a state was as follows: improvement 52, deterioration 13, no changes 11, fatal outcomes 5 cases. Improvement was more typical of adults. Deterioration indices were higher in adults as well. Gross invalidism was watched in 1 child and 1 adult. Fatal outcomes were observed only in children (p<0.05). State improvement was more frequent after total removal (p<0.05). A number of deteriorated cases was greater in subtotal removal. Reliable improvement of a state was more typical of cases with PA (90.32%), AA (77.78%) and A (76.19%) (p<0.05). A rate of postoperative deterioration was higher in cases with GB (40%) and neoplasms of another histological origin (50%).

The last years were characterized by considerable increase of a number of operations for tumors of the thalamus and marked decrease of mortality in the immediate postoperative period. The analysis of data of 17 cases, operated in 1985-1995, and 64 patients, operated in 1996-2005, revealed 4 (>20%) and only 1 (1.5%) fatal outcomes, respectively.