gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Extent of resection and long-term outcome of low-grade gliomas operated with intraoperative low- and high-field MRI resection control

Meeting Abstract

  • Anna Wolfschmidt - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Nürnberg, Deutschland
  • Christopher Nimsky - Neurochirurgische Klinik, Universitätsklinikum Marburg, Marburg, Deutschland
  • Michael Buchfelder - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Nürnberg, Deutschland
  • Peter Grummich - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Nürnberg, Deutschland
  • Andreas Stadlbauer - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Nürnberg, Deutschland; Arbeitsgruppe MR Physik, Institut für Medizinische Radiologie, Landesklinikum St.Pölten, St. Pölten, Österreich
  • Oliver Ganslandt - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Nürnberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocDI.10.13

doi: 10.3205/13dgnc263, urn:nbn:de:0183-13dgnc2630

Published: May 21, 2013

© 2013 Wolfschmidt 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: The prognostic influence of the extent of resection (EOR) of low-grade gliomas (LGG) is still a matter of debate. In this study we present long-term results of our series of LGG operated with the use of high- and low-field intraoperative MRI (iMRI).

Method: Included in this retrospective study were adults with low-grade gliomas, who underwent resective surgery with aid of iMRI to maximize EOR. Patients in whom stereotactic biopsies had been performed, were excluded. All patients were followed up in the medical records of our outpatient clinic and to a lesser extent by telephone interviews. Volumetric data were calculated for all patients operated with high field imaging. All patients were operated with functional neuronavigation. The endpoints of this analysis were progression free survival (PFS) and overall survival (OS).

Results: In the high-field group, a total of 76 patients were operated and in 52,6% a complete resection (CR) could be achieved. The PFS in the group with CR was 74 months (94,7%) and 56,5 months (80,7%) in the group with subtotal resection (STR). Recurrent tumors were detected in 11,8% in the group with CR and in 19,7% of the STR group. The mean follow-up was 72,1 months. The 5 year-OS was 98,7% in patients with CR. In the group operated with low-field MR imaging, a complete resection was achieved in 40% of 25 patients. In this group the PFS was 101,3 months. In the group with incomplete resection, the PFS was 76,5 months.

Conclusions: Our results show that extent of resection(EOR) does influence the prognosis of low grad gliomas (LGG) in regard of PFS. The rate of CR with iMRI was significantly higher than in control groups in the literature where the number of complete resections (CR) is reported to be 35%. A recent study from the group of Berger from UCSF showed that tumor remnants in the order of 10 cm3 significantly affect OS. We conclude that iMRI is a valuable tool for achieving better outcome results in LGG.