gms | German Medical Science

Objective: In recent years it became evident that patients with low-grade glioma (LGG) benefit from gross total resection (GTR) with respect to PFS and OS compared to patients receiving subtotal resection (STR) or biopsy. Furthermore GTR seems to improve seizure control. The aim of this study was to evaluate patients' outcome concerning extent of resection (EOR) using the UCSF scoring system [1].

Method: 76 Patients with initial diagnosis of LGG treated 1997–2013 were retrospectively evaluated. Inclusion criteria were: diagnosis of LGG and availability of pre-OP MRI. We evaluated PFS and OS, clinical course and treatment strategies. Furthermore the UCSF1 scoring criteria were evaluated (eloquent location, KPS, age, maximum diameter of the tumor).

Results: 44 patients with a mean follow-up of 80.3 months (range 5–288) with initial LGG were identified in our database fulfilling the inclusion criteria. 26 were male, 18 were female, mean age at diagnosis was 40 years (SD: ± 14 years, range 14–65). Concerning UCSF criteria, mean KPS was 93 (range 70–100), 26 tumors were located in eloquent areas and 18 patients had a tumor diameter >4 cm. GTR could be achieved in 18 cases, STR or biopsy of the tumor was performed in 26 cases. In the group of STR significantly more patients (n=18) experienced malignant progression whereas in the group with GTR 6 patients had malignant progression (Fisher’s exact, p=0.04).

Conclusions: In the era of molecular genetic prognostic factors GTR remains an important predictive factor for malignant progression which can be identified even in in relatively small patient populations, highlighting the importance of surgical removal. The UCSF scoring system for LGG is easily applied preoperatively helping to define the goals of the treatment for individual patients.