gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Influence of the extent of resection on morbidity in malignant gliomas surgery

Einfluss der Radikalität der Operation auf die kurz- und langfristige Morbidität bei malignen Gliomen

Meeting Abstract

  • corresponding author W. Stummer - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • U. Pichlmeier - medac GmbH, Wedel
  • J.-C. Tonn - Ludwig-Maximilians-Universität, München
  • ALA-Glioma Study Group
  • H. J. Reulen - Ludwig-Maximilians-Universität, München

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocFR.04.04

The electronic version of this article is the complete one and can be found online at:

Published: April 11, 2007

© 2007 Stummer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



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.