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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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To treat or not to treat? A retrospective assessment of survival in patients with IDH-mutated low grade glioma based on adjuvant treatment

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  • Jan Coburger - Bezirkskrankenhaus Günzburg, Günzburg, Deutschland
  • Christine Jungk - Universitätsklinikum Heidelberg, Heidelberg, Deutschland
  • Hajrullah Ahmeti - Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
  • Constantin Roder - Universitätsklinikum Tübingen, Tübingen, Deutschland
  • Florian Geßler - Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
  • Moritz Scherer - Universitätsklinikum Heidelberg, Heidelberg, Deutschland
  • Felix Schwarz - Imland Kliniken, Rendsburg, Deutschland
  • Andrej Pala - Bezirkskrankenhaus Günzburg, Günzburg, Deutschland
  • Christian Senft - Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
  • Marcos Tatagiba - Universitätsklinikum Tübingen, Tübingen, Deutschland
  • Michael Synowitz - Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
  • Andreas W. Unterberg - Universitätsklinikum Heidelberg, Heidelberg, Deutschland
  • Christian Rainer Wirtz - Bezirkskrankenhaus Günzburg, Günzburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV026

doi: 10.3205/18dgnc027, urn:nbn:de:0183-18dgnc0279

Published: June 18, 2018

© 2018 Coburger 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: Level of evidence for adjuvant treatment of diffuse WHO°II glioma (LGG) is low. Based on long-term follow up data of the RTOG 9802 trial, in high risk patients, most centers nowadays apply an combined radio/chemotherapy (RT+CT). Aim of the assessment is to compare progression free survival (PFS) of patients after a RT+CT with CT alone or patients without adjuvant treatment.

Methods: Based on a retrospective multi-center cohort of 288 patients (<18a) with diffuse WHO°II glioma, a sub-group analysis of patients with assessment of molecular markers and a confirmed IDH1 mutation was performed. We assessed PFS based on primary adjuvant treatment, age, extent of resection (EoR), recurrent surgery and oligodendroglial component in a multivariate Cox-regression model and Kaplan-Meier estimates.

Results: 121 patients matched the inclusion criteria. 40 received adjuvant treatment. Median follow up was 4.4a. Median overall PFS was 3.4a. Surprisingly, it was significantly longer without adjuvant treatment (4.3a vs. 2.8a p=0.002). Also, in high-risk patients (age

Conclusion: In our retrospective assessment, no significant advantage was found for PFS if an adjuvant treatment after resection of WHO°II IDH mutated diffuse glioma was applied. However, our data is limited by the retrospective study design and the heterogeneous indication for adjuvant treatment.