Interactions between glioma and pregnancy: insight from a 52-case multicenter series

被引：32

作者：

Peeters, Sophie ^{[1
,2
]}

Pages, Melanie ^{[2
,3
]}

Gauchotte, Guillaume ^{[4
]}

Miquel, Catherine ^{[5
]}

Cartalat-Carel, Stephanie ^{[6
]}

Guillamo, Jean-Sebastien ^{[7
]}

Capelle, Laurent ^{[8
,27
]}

Delattre, Jean-Yves ^{[9
]}

Beauchesne, Patrick ^{[10
]}

Debouverie, Marc ^{[7
]}

Fontaine, Denys ^{[11
,27
]}

Jouanneau, Emmanuel ^{[12
]}

Stecken, Jean ^{[13
]}

Menei, Philippe ^{[14
,17
]}

De Witte, Olivier ^{[15
,16
]}

Colin, Philippe ^{[18
,27
]}

Frappaz, Didier ^{[19
]}

Lesimple, Thierry ^{[20
]}

Bauchet, Luc ^{[21
,27
]}

Lopes, Manuel ^{[22
]}

Bozec, Laurence ^{[23
]}

Moyal, Elisabeth ^{[24
]}

Deroulers, Christophe ^{[25
]}

Varlet, Pascale ^{[2
,3
,28
]}

Zanello, Marc ^{[1
,2
]}

Chretien, Fabrice ^{[2
,3
]}

Oppenheim, Catherine ^{[2
,26
,27
,28
]}

Duffau, Hugues ^{[27
]}

Taillandier, Luc ^{[7
,27
]}

Pallud, Johan ^{[1
,2
,27
,28
]}

机构：

[1] St Anne Hosp, Dept Neurosurg, Paris, France

[2] Paris Descartes Univ, Sorbonne Paris Cite, Paris, France

[3] St Anne Hosp, Dept Neuropathol, Paris, France

[4] CHU Nancy, Dept Pathol, Nancy, France

[5] St Louis Hosp, Dept Pathol, Paris, France

[6] Hosp Civils Lyon, Hop Neurolog, Dept Neurooncol, Bron, France

[7] CHU Caen, Dept Neurol, Caen, France

[8] Pitie Salpetriere Univ Hosp, AP HP, Dept Neurosurg, Paris, France

[9] Pitie Salpetriere Univ Hosp, AP HP, Dept Neurooncol, Paris, France

[10] CHU Nancy, Hosp Cent, Dept Neurooncol, Nancy, France

[11] Ctr Hosp Univ Nice, Dept Neurosurg, Nice, France

[12] Hosp Civils Lyon, Neurol Hosp Pierre Wertheimer, Dept Neurosurg, Bron, France

[13] Reg Hosp, Dept Neurosurg, Orleans, France

[14] CHU Angers, Dept Neurosurg, Angers, France

[15] Univ Libre Bruxelles, Lab Expt Neurosurg, Brussels, Belgium

[16] Univ Libre Bruxelles, Multidisciplinary Res Inst, Inst Rech Interdisciplinaire Biol Humaine & Mol, Brussels, Belgium

[17] Polyclin Courlancy, Radiat Dept, Reims, France

[18] Ctr Leon Berard, Dept Pediat & Adult Neuro Oncol, Lyon, France

[19] Inst Hematol Oncol Pediat, Lyon, France

[20] Comprehens Canc Ctr & Biotrial, Rennes, France

[21] Gui Chauliac Hosp, Dept Neurosurg, Montpellier, France

[22] Argonay Private Hosp, Dept Neurosurg, Argonay, France

[23] Inst Curie Hop Rene Huguenin, Dept Med Oncol, St Cloud, France

[24] Inst Claudius Regaud, Dept Radiotherapie, Toulouse, France

[25] Univ Paris Sud, Univ Paris Diderot, IMNC Lab, CNRS, Orsay, France

[26] St Anne Hosp, Dept Neuroradiol, Paris, France

[27] REG, Reseau Etude Gliomes, Groland, France

[28] INSERM, U894, Ctr Psychiat & Neurosci, Paris, France

来源：

JOURNAL OF NEUROSURGERY | 2018年 / 128卷 / 01期

关键词：

glioma management; natural history; oncology; pregnancy; LOW-GRADE GLIOMAS; BRAIN-TUMOR; MALIGNANT GLIOMAS; CELL-GROWTH; FOLLOW-UP; MANAGEMENT; WOMEN; NEOPLASMS; SURVIVAL; SEIZURES;

D O I：

10.3171/2016.10.JNS16710

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE The goal of this study was to provide insight into the influence of gliomas on gestational outcomes, the impact of pregnancy on gliomas, and the identification of patients at risk. METHODS In this multiinstitutional retrospective study, the authors identified 52 pregnancies in 50 women diagnosed with a glioma. RESULTS For gliomas known prior to pregnancy (n = 24), we found the following: 1) An increase in the quantified imaging growth rates occurred during pregnancy in 87% of cases. 2) Clinical deterioration occurred in 38% of cases, with seizures alone resolving after delivery in 57.2% of cases. 3) Oncological treatments were immediately performed after delivery in 25% of cases. For gliomas diagnosed during pregnancy ( n = 28), we demonstrated the following: 1) The tumor was discovered during the second and third trimesters in 29% and 54% of cases, respectively, with seizures being the presenting symptom in 68% of cases. 2) The quantified imaging growth rates did not significantly decrease after delivery and before oncological treatment. 3) Clinical deterioration resolved after delivery in 21.4% of cases. 4) Oncological treatments were immediately performed after delivery in 70% of cases. Gliomas with a high grade of malignancy, negative immunoexpression of alpha-internexin, or positive immunoexpression for p53 were more likely to be associated with tumor progression during pregnancy. Deliveries were all uneventful (cesarean section in 54.5% of cases and vaginal delivery in 45.5%), and the infants were developmentally normal. CONCLUSIONS When a woman harboring a glioma envisions a pregnancy, or when a glioma is discovered in a pregnant patient, the authors suggest informing her and her partner that pregnancy may impact the evolution of the glioma clinically and radiologically. They strongly advise a multidisciplinary approach to management. CLASSIFICATION OF EVIDENCE Type of question: association; study design: case series; evidence: Class IV.

引用

页码：3 / 13

页数：11

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