Background: Intramedullary astrocytomas
account for about 1% of all CNS tumors and
6–8% of spinal cord tumors. The vast majority
of intramedullary astrocytomas are slowgrowing
lesions.
Objectives: The goal in this study was to
review a series of patients who underwent
surgical removal of intramedullary high-grade
astrocytomas, focusing on the functional
outcome and the effect of multimodality
treatment on the survival of patients with high
grade intramedullary astrocytoma.
Methods: Between June 1999 and June 2004,
22 patients underwent removal of
intramedullary high-grade astrocytomas in four
neurosurgical hospital in Baghdad/ Iraq
(Neurosurgical hospital, Al Shaheed Adnan
Hospital for Surgical Speeialticsa, Nursing
Home Hospital Lesions were located in the
cervical segment of the spinal cord in 12
patients, and patients.
Results: Histological examinations showed
10 Grade III astrocytomas and 12
glioblastomas. Only 2 of the 22 high-grade
astrocytomas could be completely removed. The
clinical postoperative status worsened in
14 patients (63.6%), was unchanged in seven
patients (31.8%), and there was one case of
intraoperative death (4.5%). None of the 22
patients showed improvement in their
neurological status postoperatively. In this series,
excluding the one intra-operative death, all
patients died of the progression of the
malignancy.
Conclusions: Surgical treatment did not
ameliorate the postoperative neurological status;
instead, in the majority of cases, it prompted a
worsening of the deficit. Radiotherapy and
chemotherapy have a little influence on the
length of survival. In this series, multimodality
treatment of intramedullary high-grade
astrocytomas has been shown to increase length
of survival without improving the neurological
status.
The economical units in the world face great and rapid challenges in all aspects, a matter that requires facing these challenges throughout continuous improving and developing in their performance to keep their competitive position "place".
The Benchmarking Technique is one of the modern managerial tools that are proved to be successful in application throughout making continuous comparisons between products or services and the best – performance levels the compete with it . This is achieved to develop its performance and give it the competitive criterion with which it faces its competitors.
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