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.