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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Contemporary outcome of low grade glioma surgery – results of a prospective multicenter series from the LoG-Glio registry

Aktuelle Ergebnisse der Operation niedriggradiger Gliome basierend auf ersten prospektiven Daten des LoG-Glio Registers

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Jan Coburger - Bezirkskrankenhaus Günzburg, Neurochirurgie, Günzburg, Deutschland
  • Constantin Roder - Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland
  • Minou Nadji-Ohl - Klinikum Stuttgart, Neurochirurgie, Stuttgart, Deutschland
  • Stefan Rückriegel - Universität Würzburg, Neurochirurgie, Würzburg, Deutschland
  • Christian von der Brelie - Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Katharina Faust - Charité Berlin, Neurochirurgie, Berlin, Deutschland
  • Franziska Löbel - Charité Berlin, Neurochirurgie, Berlin, Deutschland
  • Stefan Schommer - Klinikum Stuttgart, Neurochirurgie, Stuttgart, Deutschland
  • Mario Löhr - Universität Würzburg, Neurochirurgie, Würzburg, Deutschland
  • Nadja Grübel - Bezirkskrankenhaus Günzburg, Günzburg, Deutschland
  • Peter Vajcoczy - Charité Berlin, Neurochirurgie, Berlin, Deutschland
  • Veit Rohde - Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Ralf-Ingo Ernestus - Universität Würzburg, Neurochirurgie, Würzburg, Deutschland
  • Oliver Ganslandt - Klinikum Stuttgart, Neurochirurgie, Stuttgart, Deutschland
  • Marcos Tatagiba - Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland
  • Christian Rainer Wirtz - Universität Ulm, Neurochirurgie, Günzburg, Deutschland
  • Andrej Pala - Bezirkskrankenhaus Günzburg, Neurochirurgie, Günzburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV120

doi: 10.3205/19dgnc135, urn:nbn:de:0183-19dgnc1358

Veröffentlicht: 8. Mai 2019

© 2019 Coburger 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

Text

Objective: Diffuse low grade glioma (LGG) are often challenging to treat surgically due to their infiltrative growth. Based on the low incidence, prospective data on patients’ outcome and surgical treatment options are lacking. Aim of the study was to assess contemporary surgical outcome in a prospective cohort of patients from the LoG-Glio registry.

Methods: The LoG-Glio registry was searched for complete prospective data sets of diffuse LGG until first follow up. Patients were registered from 2016 to 2018. Demographic data including tumor location, molecular pathology, presenting symptoms, and surgical technique were assessed. Furthermore, the following outcome parameters were recorded at 3mo follow up (FU): complications, new permanent neurological deficits (nPND) and extent of resection (EoR) as determined by local radiology. Explorative testing for correlations was performed by Spearman’s Rho.

Results: 55 patients from 6 neurosurgical centers matched the inclusion criteria. The following demographic parameters were found: Astrocytoma: 51% (28 pts); Oligodendroglioma 49% (27 pts ); WHO°II 78% (43); °III 22% (12);. IDH mutation 80% (44 pts); left sided tumor 49% (27 pts); eloquent location 60% (33 pts); Main presenting symptom was epilepsy in 53% (29 pts). Awake surgery was performed in 16% (9 pts). All of them had a language eloquent lesion. Intraoperative monitoring (IOM) was performed in 70% (38 pts), intraoperative ultrasound (iUS) in 35% (19 pts) and intraoperative (i)MRI in 46% (25 pts). Complications were found in 15% (8 pts). 31% (17 pts) suffered from new deficits after surgery. 40% of severe deficits and 59% of slight deficits recovered at FU. Severe nPND remained in 5% (3 pts) and slight nPND in 15% (8 pts). A complete tumor resection (CTR) was achieved in 54% (28 pts). In 21% (11 pts), a near total resection and in 25% (13 pts), a subtotal resection was performed. Use of iUS (p<0.017) and iMRI (p<0.004) correlated with CTR. Awake surgery did not show a correlation with CTR. nPND correlated with use of IOM (p<0.036) while it did not correlate with use of intraoperative imaging and awake surgery.

Conclusion: Contemporary surgery in LGG remains challenging due to a majority of eloquent tumors resulting in a relatively high rate of permanent neurological deficits and incomplete resections. Hence, when approaching these lesions, all available tools and techniques should be meticulously used to increase EoR and improve outcome of our patients.