gms | German Medical Science

Objective: The impact of surgical resection on patients’ overall survival has been demonstrated for all types of glioma. However, due to anticipated postoperative neuropsychological sequelae, patients with gliomas infiltrating the corpus callosum rarely undergo tumor resection and mostly present in a poor neurological state. Thus, we aimed at investigating the benefit of glioma resection in the corpus callosum, hypothesizing neuropsychological deficits were mainly caused by tumor presence.

Methods: Between 01/2017 and 10/2019, all patients who underwent both, glioma resection in the corpus callosum and preoperative neuropsychological testing were identified. Neuropsychological function was equally assessed postoperatively as well as after 6 months applying a vast battery of neurocognitive tests (attention, executive functions, language, working and visual memory, bimanual manipulation, object recognition and affects).

Results: A total of 20 patients (11 female; mean age 46.8 ± 15.3 years) could be identified. Neuropsychological testing after surgery and after 6 months was possible in 13 and 10 patients, respectively, considering 2 patients not having reached the 6 months’ follow-up period to date. Interestingly, neurocognitive function declined in many domains after surgery, with significant deterioration of executive functions. After six months, only word fluency was reduced compared to preoperatively, whereas visuo-construction showed a trend to improve.

Gross total and subtotal tumor resection could be achieved in 14 and 5 patients, respectively, in one patient resection had to remain partial. Diagnosis was glioblastoma in 15 patients, anaplastic oligodendroglioma in 2 patients and anaplastic astrocytoma and diffuse astrocytoma in one patient each. Median overall survival was 15.1 ± 6.1 months, with 8 patients having died from glioblastoma during a median follow-up period of 17 months.

Conclusion: There is no long-term decline in neuropsychological function following tumor resection in the corpus callosum. In patients with gliomas infiltrating the corpus callosum the benefit of tumor resection clearly outweighs morbidity.