gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Prognostic significance of the degree of resection in supratentorial infiltrative low grade gliomas

Meeting Abstract

  • Konstantinos Gousias - Neurochirurgische Klinik, Universitätsklinikum Bonn, Deutschland
  • Leon Galushko - Neurochirurgische Klinik, Universitätsklinikum Bonn, Deutschland
  • Johannes Schramm - Neurochirurgische Klinik, Universitätsklinikum Bonn, Deutschland
  • Matthias Simon - Neurochirurgische Klinik, Universitätsklinikum Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1703

DOI: 10.3205/10dgnc174, URN: urn:nbn:de:0183-10dgnc1744

Published: September 16, 2010

© 2010 Gousias et al.
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Outline

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Objective: The effectiveness of surgical treatment of supratentorial low-grade gliomas (LGGs) continues to be debated. For the present paper we have analyzed the influence of the degree of resection (DOR) on malignant progression and patient survival in a series of 126 adult patients treated at our institution.

Methods: We evaluated all patients with infiltrative supratentorial LGGs WHO grade II operated in our institution from 1996–2007 who did not undergo radiation or chemotherapy prior to surgery. Pertinent clinical data were obtained from the patients’ charts and through telephone interviews.

Results: The mean age at diagnosis was 37 years. Mean follow-up was 70.9 months. There were 73 (58.0%) astrocytomas, 38 (30.1%) oligoastrocytomas and 15 (11.9%) oligodendrogliomas. 41 (32.5%) patients underwent a gross-total resection, 68 (54.7%) an incomplete resection, and 17 (13.5%) a biopsy only. The 5-year OS (overall survival) and PFS (progression free survival) rates were 50.0 % and 34.1 %, respectively. Tumor recurrence during follow-up occurred in 88 patients (69.8%). 84 patients had surgical treatment. 60 patients (71.4%) were found to harbor a malignant glioma including 18 (21.4%) glioblastomas. In the multivariate analysis, a greater DOR correlated with longer OS (p=0.031) and PFS (p<0.001). Further independent predictors of survival were KPS≥90 (OS, p=0.036), duration of symptoms >6 months prior to surgery (PFS, p=0.027) and smaller preoperative tumor volume (<25 vs. 25–100 vs. >100 cm3, PFS, p=0.001). Predictors of malignant progression included a lesser DOR (p<0.001) and larger tumor volumes (p=0.011). Age and histology did not correlate significantly with PFS, OS or malignant progression in the multivariate analysis.

Conclusions: A greater degree of resection (DOR) correlates significantly with the patients’ prognosis. These data favor cytoreductive surgery as the therapy of choice for LGG.