Clinical Effectiveness of Preoperative Embolization for Cerebellar Hemangioblastoma

Abstract

The cerebellar hemangioblastoma (CHB) has an abundant blood supply and deep anatomical location.Complete surgical resection is generally very difficult. This study investigated the safety and effectiveness ofpreoperative embolization followed by surgical resection of CHB in a large cohort of patients. A database of 125CHB patients with surgical resection in Beijing Tiantan Hospital between July 2006 and July 2012 was reviewed.Of those, 46 cases (experimental group) received preoperative embolization, 79 cases (control group) underwentsurgery without embolization. Patient demographics, tumor size, duration of surgery, blood loss, blood transfusion,complications and follow-up results were collected and analyzed retrospectively. In the experimental group, theKamofsky score (KS) was 80-100 in 40 cases (86.9%), 40-70 in 4 cases (8.7%), and below 40 in 2 cases (4.3%).Among 31 cases with follow-up, KS was 80-100 in 27 cases (87.1%), 40-70 in 2 cases (6.5%), and 0 in 2 cases(6.5%). In control group, KS was 80 -100 in 65 cases (82.2%), 40-70 in 6 cases (7.6%), 10-30 in 3 cases (3.8%),and 0 in 3 cases (3.8%). Among 53 cases with follow-up, KS was 80-100 in 44 cases (83.0%), 40-70 in 4 cases(7.5%), 10-30 in 1 case (1.9%), and 0 in 4 cases (7.5%). There were statistically significant differences betweenthe experimental and control groups in tumor size, duration of surgery, amount of intraoperative blood loss andtransfusion (p <0.01). However, complications (p = 0.31) and follow-up results (p = 0.76) showed no significantdifferences between groups. Selective preoperative embolization of those CHB patients with richer blood supply,higher hemorrhage risk, is safe and effective, and is a reliable adjuvant therapy for complete surgical resectionof CHB.