gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Recurrent low-grade gliomas: hit hard after malignant transformation?

Meeting Abstract

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  • Stephanie Kellermann - Uniklinik Köln, Klinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Jürgen Hampl - Uniklinik Köln, Klinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Ann-Cathrin Kohl - Uniklinik Köln, Klinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Inga Duval - Uniklinik Köln, Klinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Roland Goldbrunner - Uniklinik Köln, Klinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Stefan Grau - Uniklinik Köln, Klinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.14.07

doi: 10.3205/17dgnc460, urn:nbn:de:0183-17dgnc4605

Published: June 9, 2017

© 2017 Kellermann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: While numerous studies address the impact of extent of resection and different forms of adjuvant therapy in WHO grade II gliomas, the gap in knowledge concerning treatment options after malignant transformation is striking.

Methods: In a retrospective single-center study all adult patients with initial diagnosis of low-grade glioma between 1998 and 2015 undergoing tumor resection after malignant progression were identified. Besides demographic values, we evaluated preoperative Karnofsky performance score (KPS), histology, extent of resection and adjuvant treatment. Outcome measure was post-progression survival (PPS). For statistical calculation Kaplan–Meier estimates were used.

Results: A total of 43 patients with progressed LGG that had undergone surgery were identified. At the time of progression, the median age was 45 years and the median preoperative KPS 90%. In 25 patients (58.1%) complete resection of contrast enhancing tissue could be achieved. Median survival after re-resection was 57 months and median overall survival 137 months. Complete removal of contrast enhancing tumor tissue, adjuvant concomitant radio-chemotherapy, prior radiotherapy and oligodendroglial subtype were significantly correlated with improved PPS.

Conclusion: Patients in good clinical status with malignant transformation of previously treated low grade gliomas should receive aggressive treatment including re-resection followed by radio-chemotherapy.