gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Prognostic factors in the surgical treatment of low grade gliomas

Meeting Abstract

  • K. Majchrzak - Department of Neurosurgery in Sosnowiec, Medical University of Silesia in Katowice, Poland
  • W. Kaspera - Department of Neurosurgery in Sosnowiec, Medical University of Silesia in Katowice, Poland
  • B. Bobek-Bilewicz - Radiodiagnostics Department, Comprehensive Cancer Centre, Maria Sklodowska-Curie, Memorial Institute Branch Gliwice, Poland
  • A. Hebda - Radiodiagnostics Department, Comprehensive Cancer Centre, Maria Sklodowska-Curie, Memorial Institute Branch Gliwice, Poland
  • H. Majchrzak - Department of Neurosurgery in Sosnowiec, Medical University of Silesia in Katowice, Poland
  • P. Ładziński - Department of Neurosurgery in Sosnowiec, Medical University of Silesia in Katowice, Poland

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMI.03.05

DOI: 10.3205/11dgnc192, URN: urn:nbn:de:0183-11dgnc1928

Veröffentlicht: 28. April 2011

© 2011 Majchrzak et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: Surgical treatment of low-grade gliomas (LGG), especially those located in eloquent areas remains controversial. The aim of this study was to define prognostic factors in patients with low grade glioma.

Methods: We performed a prospective study between July 2005 and December 2010 in the Department of Neurosurgery of the Medical University of Silesia. We assessed 73 patients with a mean age of 38 years. All patients underwent a preoperative MR with the use of functional imaging (fMRI), diffusion tensor imaging (DTI) and cerebral blood volume measurements by perfusion-weighted MR imaging (rCBV). The extent of surgical resection was classified either as gross total resection (GTR), subtotal resection (STR) or partial resection (PTR). New permanent neurological deficit, new transient neurological deficit, overall survival(OS), progression-free survival (PFS) and malignant degeneration-free survival (MFS) were recorded.

Results: The study group consisted of 43 patients (58.9%) with tumor located within eloquent brain, 17 patients (23,3%) with tumor located close to eloquent brain. Gross total resection (GTR), subtotal resection (STR) and partial resection (PTR) were achieved in 31 (42,5%), 18 (24,7%), and 24 (32,9%) cases, respectively. There was no operative mortality. New permanent surgically acquired deficits were noted in 6 patients (8,2%). The remaining patients were followed for a median of 25 months. Progression and malignant progression were identified in 18 (24,7%) and 10 (13,7%) cases, respectively. Median time to progression was 16,5 months, and median time to malignant degeneration was 16,5 months. We observed 5 oncological progressions in GTR group (4 malignant) and 12 in STR/PTR group (6 malignant). GTR was independently associated with a trend of improved PFS. Tumor volume was significantly associated with OS, PFS, and MFS. Age was significantly associated with OS. Tumor subtype and KPS were significantly associated with MFS. On the basis of log-rank tests, rCBV was significantly associated with time to progression, and with time to malignant degeneration.

Conclusions: 1. The extent of surgical resection of LGG is not correlated with the presence of new permanent or new transient neurological deficits. 2. The extent of surgical resection is associated with the progression-free survival (PFS). 3. rCBV assessment could be a prognostic factor for both time to progression and time to malignant degeneration of patients with LGGs.