Publications by authors named "James P Chandler"

Purpose: To assess whether the Modified 5 (mFI-5) and 11 (mFI-11) Factor Frailty Indices associate with postoperative mortality, complications, and functional benefit in supratentorial meningioma patients aged over 80 years.

Methods: Baseline characteristics were collected from eight centers. Based on the patients' preoperative status and comorbidities, frailty was assessed by the mFI-5 and mFI-11.

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  • * New techniques like whole-transcriptome and single-cell sequencing identified a specific immune cell population, MG-Act, in certain pediatric gliomas, which express the TIM3 protein linked to inflammation and immune response.
  • * Treating a mouse model of low-grade gliomas with anti-TIM3 significantly increased survival compared to standard treatments, suggesting that anti-TIM3 could be a promising option for clinical trials targeting pediatric MAPK-driven gliomas.
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Background And Objective: Patients who undergo gross total resection (GTR) of Central Nervous System World Health Organization (WHO) grade 1 meningioma constitute a "low-risk" group, but some low-risk meningiomas can recur despite reassuring clinical and histological features. In this study, gene expression values in newly diagnosed WHO grade 1 meningiomas that had undergone GTR were evaluated for their association with recurrence.

Methods: This was a retrospective, international, multicenter cohort study that included WHO grade 1 meningiomas that underwent GTR, as first treatment, based on postoperative magnetic resonance imaging.

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Objective: To preserve facial nerve function in vestibular schwannoma (VS) microsurgery, some have advocated subtotal resection (STR) if the tumor is densely adherent to a thinned facial nerve. The objective of this study was to determine if residual volume is associated with progression and whether there is a threshold residual volume that should be pursued during STR to prevent recurrence. A secondary objective of this study was to determine whether facial nerve function at last follow-up was associated with extent of resection (EOR).

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  • The study investigates the clinical characteristics and outcomes of trigeminal schwannoma (TS) surgical resections across two institutions from 2004 to 2022, analyzing data from 30 patients.
  • Most patients were middle-aged, with common symptoms including sensory loss and headaches; tumors primarily consisted of mixed cystic-solid types with an average diameter of 3.3 cm.
  • Although 87% of patients reported symptom improvements after surgery, there were notable risks, with 17% experiencing temporary and 10% experiencing permanent cranial nerve deficits.
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  • Meningioma classification and treatment have advanced significantly since their early descriptions in the 1920s, focusing on improving prognostication through histopathology, radiography, and molecular profiling.
  • Accurate classification is vital for patient management, involving monitoring, surgery, radiotherapy, and potential clinical trials, primarily guided by WHO grade, extent of resection, and patient features.
  • Recent research has identified molecular markers related to the disease's aggressiveness and response to treatment, though challenges remain in applying these discoveries effectively in clinical settings.
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Objective: Parasagittal meningiomas (PM) are treated with primary microsurgery, radiosurgery (SRS), or surgery with adjuvant radiation. We investigated predictors of tumor progression requiring salvage surgery or radiation treatment. We sought to determine whether primary treatment modality, or radiologic, histologic, and clinical variables were associated with tumor progression requiring salvage treatment.

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  • - The study aimed to analyze the relationship between obesity and meningioma in patients undergoing craniotomy, comparing male and female patients' BMI and survival outcomes with those facing other intracranial tumors.
  • - Researchers used data from the National Surgical Quality Improvement Program (NSQIP) and collected additional institutional data, finding that both male and female meningioma patients were more likely to be overweight or obese compared to patients with other tumors.
  • - Meningiomas were found more often in the skull base among males, but the progression-free survival (PFS) rates did not differ between obese and nonobese patients of either gender, with obesity increasing the risk of pulmonary embolism in both groups.
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Surgery is the mainstay of treatment for meningioma, the most common primary intracranial tumor, but improvements in meningioma risk stratification are needed and indications for postoperative radiotherapy are controversial. Here we develop a targeted gene expression biomarker that predicts meningioma outcomes and radiotherapy responses. Using a discovery cohort of 173 meningiomas, we developed a 34-gene expression risk score and performed clinical and analytical validation of this biomarker on independent meningiomas from 12 institutions across 3 continents (N = 1,856), including 103 meningiomas from a prospective clinical trial.

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 Vestibular schwannomas (VSs) are treated with microsurgery and/or radiosurgery. Repeat resection is rare, and few studies have reported postoperative outcomes. The objective of this study was to describe clinical characteristics and outcomes in patients undergoing repeat surgery for VS.

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Background And Objectives: Demographic changes will lead to an increase in old patients, a population with significant risk of postoperative morbidity and mortality, requiring neurosurgery for meningiomas. This multicenter study aims to report neurofunctional status after resection of patients with supratentorial meningioma aged 80 years or older, to identify factors associated with outcome, and to validate a previously proposed decision support tool.

Methods: Neurofunctional status was assessed by the Karnofsky Performance Scale (KPS).

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  • Trigeminal schwannomas (TS) are usually non-cancerous tumors, but they can sometimes be large or cause problems, leading to the need for surgery.
  • A study collected data from 26 research papers about 974 patients who had surgery for TS, focusing on their experiences and outcomes.
  • The study found that patients who had a complete removal of the tumor (gross total resection) had a much lower chance of the tumor coming back compared to those who didn’t get it all removed.
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Background: The VS-5 index was recently proposed to predict complications, nonroutine discharge, length of stay (LOS), and cost after vestibular schwannoma (VS) resection. The VS-5 ranges from 0-17.86, and a score ≥2 was proposed as being predictive of postoperative adverse events.

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Supratentorial non-skull base meningiomas are the most common primary central nervous system tumor subtype. An understanding of their pathophysiology, imaging characteristics, and clinical management options will prove of substantial value to the multi-disciplinary team which may be involved in their care. Extensive review of the broad literature on the topic is conducted.

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Neuro-oncology encompasses a broad field focusing on an array of neoplasms, many of which can mimic several diseases. Neurologists will often be involved in the initial diagnostic evaluation and management of these patients. Their insight is central to optimizing the diagnostic yield and providing high-level clinical care.

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Objective: Foramen magnum meningiomas (FMMs) pose a unique challenge given their intimate anatomical relationship with the craniovertebral junction. While resection has been studied extensively, much less has been reported about the use of stereotactic radiosurgery (SRS) for FMMs. This study includes what is to the authors' knowledge the first systematic review in the literature that summarizes patient and treatment characteristics and synthesizes outcomes following SRS for FMMs.

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Background: Meningioma is the most common primary intracranial tumor in adults. A subset of these tumors recur and invade the brain, even after surgery and radiation, resulting in significant disability. There is currently no standard-of-care chemotherapy for meningiomas.

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Objective: Gamma Knife (GK) stereotactic radiosurgery (SRS) is increasingly used as an initial treatment for patients with 10 or more brain metastases. However, the clinical and dosimetric consequences of this practice are not well established.

Methods: We performed a single-institution, retrospective analysis of 30 patients who received Gamma Knife SRS for 10 or more brain metastases in 1 session.

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Background: Malignant glioma is the most common and lethal primary brain tumour, with dismal survival rates and no effective treatment. We examined the safety and activity of NSC-CRAd-S-pk7, an engineered oncolytic adenovirus delivered by neural stem cells (NSCs), in patients with newly diagnosed high-grade glioma.

Methods: This was a first-in-human, open-label, phase 1, dose-escalation trial done to determine the maximal tolerated dose of NSC-CRAd-S-pk7, following a 3 + 3 design.

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Nevus of Ota, also known as oculodermal melanocytosis, is a benign melanocytic lesion that develops along the distribution of the V1 and V2 branches of the trigeminal nerve. Prior reports have described the typical imaging and clinical features of nevus of Ota. We present a rare case of a 31 year-old female with midface tumors and presumed hemorrhage into an orbital lesion in the setting of nevus of Ota resulting in acute loss of vision.

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Background: The influence of the surgeon's preoperative goal regarding the extent of tumor resection on patient outcomes has not been carefully studied among patients with nonfunctioning pituitary adenomas.

Objective: To analyze the relationship between surgical tumor removal goal and patient outcomes in a prospective multicenter study.

Methods: Centrally adjudicated extent of tumor resection (gross total resection [GTR] and subtotal resection [STR]) data were analyzed using standard univariate and multivariable analyses.

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Objective: Many surgeons have adopted fully endoscopic over microscopic transsphenoidal surgery for nonfunctioning pituitary tumors, although no high-quality evidence demonstrates superior patient outcomes with endoscopic surgery. The goal of this analysis was to compare these techniques in a prospective multicenter controlled study.

Methods: Extent of tumor resection was compared after endoscopic or microscopic transsphenoidal surgery in adults with nonfunctioning adenomas.

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Purpose: We aimed to determine the efficacy of gamma knife stereotactic radiosurgery (SRS) to control brain metastases (BM) from GI primaries and report on the patient outcomes.

Materials/methods: We retrospectively evaluated patients who had undergone SRS at our institution for the treatment BM from GI primaries from 2000 to 2016. Actuarial rates for overall survival (OS) and local control (LC) were calculated.

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Purpose: To study whether the clinical outcome and molecular biology of gliomas in African-American patients fundamentally differ from those occurring in Whites.

Methods: The clinical information and molecular profiles (including gene expression array, non-silent somatic mutation, DNA methylation and protein expression) were downloaded from The Cancer genome atlas (TCGA). Electronic medical records were abstracted from Northwestern Medicine Enterprise Data Warehouse (NMEDW) for analysis as well.

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