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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

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Is ALA-induced fluorescence a novel and independent biomarker of inherent malignant degeneration in low-grade gliomas?

Meeting Abstract

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  • Mohammed Jaber - Klinik für Neurochirurgie, Westfälische-Willhelms-Universität, Münster, Germany
  • Christian Ewelt - Klinik für Neurochirurgie, Westfälische-Willhelms-Universität, Münster, Germany
  • Johannes Wölfer - Klinik für Neurochirurgie, Westfälische-Willhelms-Universität, Münster, Germany
  • Martin Hasselblatt - Institut für Neuropathologie, Westfälische-Willhelms-Universität, Münster, Germany
  • Walter Stummer - Klinik für Neurochirurgie, Westfälische-Willhelms-Universität, Münster, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.08.03

doi: 10.3205/16dgnc138, urn:nbn:de:0183-16dgnc1381

Veröffentlicht: 8. Juni 2016

© 2016 Jaber et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

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Objective: Approximately only a small fraction of low-grade gliomas (LGGs) displays visible PPIX fluorescence during surgery, after 5-ALA administration. We wanted to determine if PPIX positive LGGs differed in prognosis from non-PPIX positive LGGs and whether this was reflected by molecular factors, which are known to correlate with LGG.

Method: We retrospectively analyzed 78 consecutive cases of LGG, operated on with 5-ALA, between 1/10 and 1/16, as documented in our prospective glioma data base. IDH1 (R132H)-mutation status, Ki67/MIB1, tumor size, patient-age, KPS and contrast-enhancement were assessed and related to time to malignant deterioration (TMD).

Results: Median follow-up was 32 months (95% CI: 23.1-32.8). 21 (16%) of 78 LGG patients showed PP IX fluorescence. The Ki67/MIB1-index was the same for fluorescing and non-fluorescing tumors (4,03 vs. 5,05, p= 0,23). No significant relation was observed between fluorescence and IDH1. TMD was significantly shorter in IDH1 wild type tumors compared to mutated tumor (46,4 vs. 60.1 months, P=0.028). Independently, TMD in ALA positive LGG, was significantly shorter than in ALA negative tumors (38.0 to 58.0 months, p =0.026). No differences in age, KPS, tumor size or contrast-enhancement were found.

Conclusions: ALA induced PPIX fluorescence appears to be a marker of inherent malignant degeneration, independent of know prognostic patient characteristics of tumor molecular factors.