gms | German Medical Science

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

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Impact of Intra-operative MRI and multimodal neuronavigation on health-related quality of life and survival in adults with high-grade gliomas: a prospective controlled study

Meeting Abstract

  • Xiaolei Chen - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Gang Zheng - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Sheng Hu - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Jingjiang Li - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Fangye Li - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Jiashu Zhang - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Bai-nan Xu - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China

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. DocMO.17.04

doi: 10.3205/13dgnc150, urn:nbn:de:0183-13dgnc1508

Published: May 21, 2013

© 2013 Chen et al.
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Outline

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Objective: The value of intra-operative MRI for the treatment of high-grade gliomas (HGGs) still remains controversial. This study was conducted to evaluate the impact of 1.5T intra-operative MRI (iMRI) and multimodal neuronavigation on the health-related quality of life (HRQOL) and on the survival for the treatment of patients with HGGs.

Method: From February 2009 to February 2012, a consecutive series of 512 adult patients with cerebral lesions suspicious of HGGs were prospectively enrolled. According to the post-operative histological diagnosis, 9 patients were excluded from this study. The patients were allocated into iMRI group (n=299) and control group (n=204). Patients in iMRI group underwent tumor resection with 1.5T iMRI and integrated multimodal navigation, while patients in control group had standard microsurgical resection and multimodal navigation. The extent of resection (EOR) and survival time were examined and compared. The 36-Item Health Surveys (SF-36) were completed by patients and analyzed to assess HRQOL at study entry, at 3-month, and at the 6-month follow-up.

Results: In study group, iMRI detected tumor remnants in 90 patients and resulted in final gross total resection (GTR) for 32 patients (GTR increased from 209 [69.9%] to 241 [80.6%] patients) in iMRI group. In the control group, early post-operative MRI (within 48 hours) revealed residual tumor in 60 cases. Final GTR in control group was 70.6%. There was significant difference for both GTR and EoR between iMRI and control group (GTR, 80.6% vs 70.6%; EoR, 95.5% vs 82.3%) respectively. Median survival was 14 months in the iMRI group and 8 months in the control group (P< .0001). HRQOL data were available for entry time, 3-month, and 6-month follow-up for 90.1%, 82.2%, and 78.3% of patients in iMRI group, respectively, while in control group, these data were available for 90.8%, 72.2%, and 68.7% of patients. There was significant difference for 3-month and 6-month HRQOL between iMRI and the control group (p<0.05). Patients, who underwent a gross total resection or had a higher EoR were more likely to have improved HRQOL (p<0.003) at their 3-month or 6-month follow-up evaluation.

Conclusions: We demonstrated that iMRI and multimodal neuronavigation significantly contribute to GTR and higher EoR, and was associated with longer survival and improved HRQOL over time for patients with high-grade gliomas.