gms | German Medical Science

Objective: In malignant glioma surgery, the degree of resection has been related to long-term outcome. However, more extensive resections may result in greater neurological deficits. To determine short and long-term neurological repercussions related to the degree of resection, neurological outcome, as determined in the multicenter ALA glioma resection study, was analyzed.

Methods: Data on 130 control patients from the ALA study were analyzed regarding pre- and postoperative (48 hours, 7 days, 6 weeks) NIH stroke scores for assessing individual neurological functions. Furthermore KPS was assessed during the follow-up period, comparing patients with complete (n=47) and incomplete (n=83) resections on early MRI.

Results: More patients deteriorated and less patients improved in the complete resection group regarding their NIH stroke score status at 48 hours (p=0.031, exact Wilcoxon-Mann-Whitney-Test) and 7 days after surgery (p=0.0067) compared to the incomplete resection group. No significant differences were noted 6 weeks after surgery (p=0.54). Conversely, regarding the global function measure KPS, patients with incomplete resections deteriorated to <70% significantly earlier than patients with complete resections (p=0.0203, log rank).

Conclusions: Complete resections of malignant gliomas are associated with more short-term deficits of individual functions which were no longer detectable 6 weeks after surgery, whereas general function deteriorated more rapidly in patients with incomplete resections. These observations underline the long-term benefits of complete resections in malignant glioma surgery.