Publications by authors named "Charissa Jessurun"
Onco-functional outcome after resection for eloquent glioblastoma (OFO): A propensity-score matched analysis of an international, multicentre, cohort study.
Eur J Cancer
November 2024
Article Synopsis
- The study aimed to create a new onco-functional outcome (OFO) classification for glioblastoma patients, combining the goals of complete tumor resection and avoiding functional loss into four categories.
- Analyzing data from 858 patients over ten years, they found that the OFO classification significantly influenced overall survival (OS) and progression-free survival (PFS) rates, especially in certain tumor types.
- The results showed that achieving the best outcome (OFO1) was linked to improved survival rates and higher likelihood of receiving additional therapy, particularly with awake craniotomy procedures being more effective in avoiding deficits.
Background: The impact of extent of resection (EOR), residual tumor volume (RTV), and gross-total resection (GTR) in glioblastoma subgroups is currently unknown. This study aimed to analyze their impact on patient subgroups in relation to neurological and functional outcomes.
Methods: Patients with tumor resection for eloquent glioblastoma between 2010 and 2020 at 4 tertiary centers were recruited from a cohort of 3919 patients.
Objective: The incidence of leptomeningeal disease (LMD) has increased as treatments for brain metastases (BMs) have improved and patients with metastatic disease are living longer. Sample sizes of individual studies investigating LMD after surgery for BMs and its risk factors have been limited, ranging from 200 to 400 patients at risk for LMD, which only allows the use of conventional biostatistics. Here, the authors used machine learning techniques to enhance LMD prediction in a cohort of surgically treated BMs.
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- * Out of 170 patients, 43.5% experienced a second local recurrence at a median of 7 months post-surgery.
- * Key risk factors for a poorer outcome were found to be subtotal resection of the initial BM and the location of the tumor in the infratentorial region.
Background: Awake mapping has been associated with decreased neurological deficits and increased extent of resection in eloquent glioma resections. However, its effect within clinically relevant glioblastoma subgroups remains poorly understood. We aimed to assess the benefit of this technique in subgroups of patients with glioblastomas based on age, preoperative neurological morbidity, and Karnofsky Performance Score (KPS).
View Article and Find Full Text PDFObjectives: COVID-19 presents a risk for delays to stroke treatment. We examined how COVID-19 affected stroke response times.
Methods: A literature search was conducted to identify articles covering stroke during COVID-19 that included time metrics data pre- and post-pandemic.
Article Synopsis
- The study investigates the varying practices of steroid dosing and tapering schedules among neurosurgeons treating brain tumors, as there is little evidence on the best approach.
- An electronic survey with 27 questions was distributed to neurosurgeons worldwide, receiving 175 responses spread across 55 countries, with a high percentage prescribing perioperative steroids.
- Results showed a wide range of steroid doses and schedules, primarily using dexamethasone, highlighting the need for future research to establish standardized guidelines for optimal dosing practices.
Article Synopsis
- - Leptomeningeal disease (LMD) is a severe complication of brain metastases, leading to a poor prognosis with a median survival of only 2-4 months, and this study aimed to identify risk factors associated with LMD after surgery for brain metastases.
- - The meta-analysis included 13 studies with over 2,100 patients, finding that 16.1% developed LMD, with significant risk factors such as tumor size, location, surgical methods, and specifically, breast cancer as the primary tumor type and multiple brain metastases being key contributors.
- - The research emphasized the need to consider various risk factors, as breast cancer origins and having multiple brain metastases notably increase the likelihood of developing
Article Synopsis
- Immune checkpoint inhibitors (ICI) are beneficial for cancer patients, including those with brain metastases (BMs), but the interaction with steroids is unclear.
- A systematic literature review analyzed data from 15 studies involving 1102 BM patients, with 32.1% using steroids, revealing worse overall survival (OS) and progression-free survival (PFS) for the steroid group compared to those not using steroids.
- The findings highlight the need for further research on how steroids affect treatment outcomes in BM patients receiving ICI, particularly regarding dosage and timing.
Article Synopsis
- The study reviews literature on the dosage and schedule of dexamethasone (DXM) and its impact on clinical outcomes for patients with malignant brain tumors, highlighting the need for evidence-based practices.
- A systematic search revealed 15 relevant studies, indicating that a common dose of 16 mg (4 mg four times a day) is used, but differences among studies prevented a comprehensive analysis.
- Findings indicate that higher DXM doses may lead to more adverse effects without improving patient outcomes, suggesting that lower doses might be just as effective, though further research is urgently needed, particularly with the rise of immunotherapy treatments.
Background: Immune checkpoint inhibitors (ICIs), targeting CTLA-4 or PD-1 molecules, have shown impressive therapeutic results. However, only 20-40% of advanced melanoma patients have durable responses to ICI, and these positive effects must be balanced against severe off-target immune toxicity and high costs. This urges the development of predictive biomarkers for ICI response to select patients with likely clinical benefit from treatment.
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