Stereotactic Radiosurgery for Partially Resected XXXX .

@entity1 @entity7026 @entity2758 @entity548
OBJECTIVE: Incomplete microsurgical resection of @entity7026 ( @entity2758 ) occurs uncommonly. However, such @entity1 harboring postoperative residual nidi remain exposed to the risk of @entity548 and are therefore reasonable candidates for further intervention. The goals of this retrospective case-control study are to analyze the radiosurgery outcomes for partially resected AVMs and determine the effect of prior resection on @entity2758 radiosurgery outcomes. METHODS: We evaluated a prospective database of @entity2758 @entity1 treated with radiosurgery from 1989-2013. Previously resected AVMs with radiologic follow-up >= 2 years or nidus obliteration were selected for analysis and matched, in a 1:1 fashion and blinded to outcome, to previously unresected AVMs. Statistical analyses were performed to assess relationship between prior resection and @entity2758 radiosurgery outcomes. RESULTS: The matching process yielded 88 @entity1 in each of the previously resected and unresected @entity2758 cohorts. In the resected @entity2758 cohort, the @entity2758 rates at 3 and 5 years were 47% and 75%, respectively; the rates of radiologic and symptomatic radiation-induced changes (RICs) were 10% and 3%, respectively; and the annual postradiosurgery @entity548 risk was 1.1%. The lack of prior @entity2758 resection (P < 0.001) and superficial @entity2758 location (P  = 0.009) were independent predictors of radiologic RIC. The actuarial rates of obliteration (P  = 0.849) and postradiosurgery @entity548 (P  = 0.548) were not significantly different between the resected and unresected @entity2758 cohorts. CONCLUSIONS: Radiosurgery affords a reasonable risk-to-benefit profile for incompletely resected AVMs. For those with a small-volume residual nidus after resection, radiosurgery should be considered an effective alternative to repeat resection.
