Dataset Information

Age and Tumor Volume Predict Growth of Carotid and Vagal Body Paragangliomas.

ABSTRACT: Objective ?Treatment for head and neck paragangliomas (HNGPL) can be more harmful than the disease. After diagnosis, an initial period of surveillance is often indicated, and surgery or radiotherapy is reserved for progressive disease. With the aim to optimize this "wait and scan" strategy, we studied growth and possible predictors. Design ?A retrospective cohort study was conducted. Setting ?This study was conducted at a tertiary referral center for patients with HNGPL. Methods ?Tumor volume was estimated for 184 SDHD -related carotid and vagal body paragangliomas using sequential magnetic resonance imaging. Cox regression was used to study predictors of tumor growth. Results ?The estimated fraction of growing tumors ranged from 0.42 after 1?year of follow-up to 0.85 after 11 years. A median growth rate of 10.4 and 12.0% per year was observed for carotid and vagal body tumors, respectively. Tumor location, initial volume, and age ( p ?

SUBMITTER: Heesterman BL

PROVIDER: S-EPMC5680030 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Age and Tumor Volume Predict Growth of Carotid and Vagal Body Paragangliomas.

Heesterman Berdine L BL de Pont Lisa M H LMH Verbist Berit M BM van der Mey Andel G L AGL Corssmit Eleonora P M EPM Hes Frederik J FJ van Benthem Peter Paul G PPG Jansen Jeroen C JC

Journal of neurological surgery. Part B, Skull base 20170731 6

Objective Treatment for head and neck paragangliomas (HNGPL) can be more harmful than the disease. After diagnosis, an initial period of surveillance is often indicated, and surgery or radiotherapy is reserved for progressive disease. With the aim to optimize this "wait and scan" strategy, we studied growth and possible predictors. Design A retrospective cohort study was conducted. Setting This study was conducted at a tertiary referral center for patients with HNGPL. ...[more]

PMID: 29134169

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Project description:BackgroundCarotid body tumors (CBTs) are rare entities for which surgical resection remains the gold standard. Given their hypervascularity, preoperative embolization is often used; however, controversy exists over whether a benefit is associated. Proponents of embolization argue that it minimizes blood loss and complications. Critics argue that cost and stroke outweigh benefits. This study aimed to investigate the impact of embolization on outcomes following CBT resection.MethodsPatients undergoing CBT resection were identified using the Healthcare Cost and Utilization Project State Inpatient Database for 5 states between 2006 and 2013. Patients were divided into 2 groups: carotid body tumor resection alone (CBTR) and carotid body tumor resection with preoperative arterial embolization (CBETR). Descriptive statistics were calculated using arithmetic means with standard deviations for continuous variables and proportions for categorical variables. Patients were propensity score matched on the basis of sex, age, race, insurance, and comorbidity prior to analysis. Risk-adjusted odds of mortality, stroke, nerve injury, blood loss, and length of stay (LOS) were calculated using mixed-effects regression models with fixed effects for age, race, sex, and comorbidities.ResultsA total of 547 patients were identified. Of these, 472 patients underwent CBTR and 75 underwent CBETR. Mean age was 54.7 ± 16 years. Mean number of days between embolization and resection was 0.65 ± 0.72 days (range 0-3). When compared with CBTR, there were no significant differences in mortality for CBETR (1.35% vs. 0%, P = 0.316), cranial nerve injury (2.7% vs. 0%, P = 0.48), and blood loss (2.7% vs. 6.8%, P = 0.245). Following risk adjustment, CBETR increased the odds of prolonged LOS (odds ratio 5.3, 95% confidence interval 2.1-13.3).ConclusionsCBT resection is a relatively rare procedure. The utility of preoperative tumor embolization has been questioned. This study demonstrates no benefit of preoperative tumor embolization.

Dataset Information

Age and Tumor Volume Predict Growth of Carotid and Vagal Body Paragangliomas.

Publications

Age and Tumor Volume Predict Growth of Carotid and Vagal Body Paragangliomas.

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