scholarly journals The Value of Pre- and Intraoperative Adjuncts on the Extent of Resection of Hemispheric Low-Grade Gliomas: A Retrospective Analysis

2015 ◽  
Vol 77 (02) ◽  
pp. 079-087 ◽  
Author(s):  
Olutayo Olubiyi ◽  
Aysegul Ozdemir ◽  
Tom Lee ◽  
Laura Rigolo ◽  
Alexandra Golby ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Extent Of Resection ◽  
Low Grade ◽  
Low Grade Gliomas ◽  
Intraoperative Adjuncts

scholarly journals The Role of Extent of Resection in IDH1 Wild-Type or Mutant Low-Grade Gliomas

Neurosurgery ◽  
2017 ◽  
Vol 82 (6) ◽  
pp. 808-814 ◽  
Author(s):  
Toral Patel ◽  
Evan D Bander ◽  
Rachael A Venn ◽  
Tiffany Powell ◽  
Gustav Young-Min Cederquist ◽  
...  
Keyword(s):  
Cox Regression ◽  
Extent Of Resection ◽  
World Health ◽  
Low Grade ◽  
Wild Type ◽  
Who Grade ◽  
Cox Regression Analysis ◽  
Low Grade Gliomas ◽  
Grade Ii ◽  
The Impact

Abstract BACKGROUND Maximizing extent of resection (EOR) improves outcomes in adults with World Health Organization (WHO) grade II low-grade gliomas (LGG). However, recent studies demonstrate that LGGs bearing a mutation in the isocitrate dehydrogenase 1 (IDH1) gene are a distinct molecular and clinical entity. It remains unclear whether maximizing EOR confers an equivalent clinical benefit in IDH mutated (mtIDH) and IDH wild-type (wtIDH) LGGs. OBJECTIVE To assess the impact of EOR on malignant progression-free survival (MPFS) and overall survival (OS) in mtIDH and wtIDH LGGs. METHODS We performed a retrospective review of 74 patients with WHO grade II gliomas and known IDH mutational status undergoing resection at a single institution. EOR was assessed with quantitative 3-dimensional volumetric analysis. The effect of predictor variables on MPFS and OS was analyzed with Cox regression models and the Kaplan–Meier method. RESULTS Fifty-two (70%) mtIDH patients and 22 (30%) wtIDH patients were included. Median preoperative tumor volume was 37.4 cm3; median EOR of 57.6% was achieved. Univariate Cox regression analysis confirmed EOR as a prognostic factor for the entire cohort. However, stratifying by IDH status demonstrates that greater EOR independently prolonged MPFS and OS for wtIDH patients (hazard ratio [HR] = 0.002 [95% confidence interval {CI} 0.000-0.074] and HR = 0.001 [95% CI 0.00-0.108], respectively), but not for mtIDH patients (HR = 0.84 [95% CI 0.17-4.13] and HR = 2.99 [95% CI 0.15-61.66], respectively). CONCLUSION Increasing EOR confers oncologic and survival benefits in IDH1 wtLGGs, but the impact on IDH1 mtLGGs requires further study.

scholarly journals Therapeutic and Prognostic Implications of BRAF V600E in Pediatric Low-Grade Gliomas

2017 ◽  
Vol 35 (25) ◽  
pp. 2934-2941 ◽  
Author(s):  
Alvaro Lassaletta ◽  
Michal Zapotocky ◽  
Matthew Mistry ◽  
Vijay Ramaswamy ◽  
Marion Honnorat ◽  
...  
Keyword(s):  
Quantitative Imaging ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
Braf V600e ◽  
Low Grade ◽  
Low Grade Gliomas ◽  
Molecular Stratification ◽  
Treatment Data ◽  
Poor Outcomes ◽  
Independent Cohort

Purpose BRAF V600E is a potentially highly targetable mutation detected in a subset of pediatric low-grade gliomas (PLGGs). Its biologic and clinical effect within this diverse group of tumors remains unknown. Patients and Methods A combined clinical and genetic institutional study of patients with PLGGs with long-term follow-up was performed (N = 510). Clinical and treatment data of patients with BRAF V600E mutated PLGG (n = 99) were compared with a large international independent cohort of patients with BRAF V600E mutated-PLGG (n = 180). Results BRAF V600E mutation was detected in 69 of 405 patients (17%) with PLGG across a broad spectrum of histologies and sites, including midline locations, which are not often routinely biopsied in clinical practice. Patients with BRAF V600E PLGG exhibited poor outcomes after chemotherapy and radiation therapies that resulted in a 10-year progression-free survival of 27% (95% CI, 12.1% to 41.9%) and 60.2% (95% CI, 53.3% to 67.1%) for BRAF V600E and wild-type PLGG, respectively ( P < .001). Additional multivariable clinical and molecular stratification revealed that the extent of resection and CDKN2A deletion contributed independently to poor outcome in BRAF V600E PLGG. A similar independent role for CDKN2A and resection on outcome were observed in the independent cohort. Quantitative imaging analysis revealed progressive disease and a lack of response to conventional chemotherapy in most patients with BRAF V600E PLGG. Conclusion BRAF V600E PLGG constitutes a distinct entity with poor prognosis when treated with current adjuvant therapy.

Clinical outcome of surgically treated low-grade gliomas: A retrospective analysis of a single institute

2013 ◽  
Vol 115 (12) ◽  
pp. 2508-2513 ◽  
Author(s):  
Erhan Turkoglu ◽  
Bora Gurer ◽  
Ahmet M. Sanli ◽  
Habibullah Dolgun ◽  
Levent Gurses ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Retrospective Analysis ◽  
Low Grade ◽  
Low Grade Gliomas

Low-grade gliomas in older patients: a retrospective analysis of prognostic factors

2008 ◽  
Vol 90 (3) ◽  
pp. 341-350 ◽  
Author(s):  
Nader Pouratian ◽  
Melike Mut ◽  
Jay Jagannathan ◽  
M. Beatriz Lopes ◽  
Mark E. Shaffrey ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Analysis ◽  
Older Patients ◽  
Low Grade ◽  
Low Grade Gliomas

scholarly journals Prognostic significance of clinical parameters in patients with cerebral low-grade glioma

2020 ◽  
pp. 85-85
Author(s):  
Milos Jokovic ◽  
Radovan Mijalcic ◽  
Vladimir Bascarevic ◽  
Nemanja Jovanovic
Keyword(s):  
Overall Survival ◽  
Tumor Biology ◽  
Prognostic Significance ◽  
Extent Of Resection ◽  
Categorical Variables ◽  
Low Grade ◽  
Clinical Parameters ◽  
Site Location ◽  
Who Grade ◽  
Low Grade Gliomas

Introduction/Objective. Low-grade gliomas (LGG) affect younger adults and carry a favorable prognosis. We aim to describe clinical patterns of low-grade gliomas as well as prognosis in different groups of patients. Our intention was to determine clinical parameters that may affect prognosis, and whether a greater extent of resection would increase the long-term progression-free or overall survival of patients with low-grade gliomas. Methods. We analyzed data obtained from the files of the patients with a diagnosis of WHO grade II gliomas. The relationships among categorical variables were analyzed using standard statistical tools and a 95% confidence interval (CI). Results. We analyzed 118 patients with median age of 34 years. Over 57% were male and the primary site location was the cerebrum. All these patients were operated on and some of them received radiation and/or chemotherapy. Median overall survival was 9.6 years and better prognosis is associated with younger age, frontal and noneloquent zone location, seizures as the first symptom of disease and gross total resection of the tumor. Indications for early surgery are increased intracranial pressure, preoperative neurologic deficit, tumor size larger than 6 cm with contrast enhancement and older age. Conclusion. Tumor location, 1p/19q co-deletion and age were the main determinants of treatment received and overall survival, likely reflecting tumor biology differences. Any form of treatment was preferred over watchful waiting. This study found that a greater extent of resection could significantly increase the overall survival of patients with low-grade gliomas.

scholarly journals Evaluating pediatric spinal low-grade gliomas: a 30-year retrospective analysis

2019 ◽  
Vol 145 (3) ◽  
pp. 519-529 ◽  
Author(s):  
Steven S. Carey ◽  
Zsila Sadighi ◽  
Shengjie Wu ◽  
Jason Chiang ◽  
Giles W. Robinson ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Low Grade ◽  
Low Grade Gliomas

Circumferential sulcus-guided resection technique for improved outcomes of low-grade gliomas

2022 ◽  
pp. 1-11
Keyword(s):  
Extent Of Resection ◽  
Neurological Complications ◽  
Low Grade ◽  
Newly Diagnosed ◽  
Imaging Data ◽  
Volumetric Imaging ◽  
Exact Test ◽  
Low Grade Gliomas ◽  
Presenting Symptoms ◽  
Piecemeal Resection

OBJECTIVE Many neurosurgeons resect nonenhancing low-grade gliomas (LGGs) by using an inside-out piecemeal resection (PMR) technique. At the authors’ institution they have increasingly used a circumferential, perilesional, sulcus-guided resection (SGR) technique. This technique has not been well described and there are limited data on its effectiveness. The authors describe the SGR technique and assess the extent to which SGR correlates with extent of resection and neurological outcome. METHODS The authors identified all patients with newly diagnosed LGGs who underwent resection at their institution over a 22-year period. Demographics, presenting symptoms, intraoperative data, method of resection (SGR or PMR), volumetric imaging data, and postoperative outcomes were obtained. Univariate analyses used ANOVA and Fisher’s exact test. Multivariate analyses were performed using multivariate logistic regression. RESULTS Newly diagnosed LGGs were resected in 519 patients, 208 (40%) using an SGR technique and 311 (60%) using a PMR technique. The median extent of resection in the SGR group was 84%, compared with 77% in the PMR group (p = 0.019). In multivariate analysis, SGR was independently associated with a higher rate of complete (100%) resection (27% vs 18%) (OR 1.7, 95% CI 1.1–2.6; p = 0.03). SGR was also associated with a statistical trend toward lower rates of postoperative neurological complications (11% vs 16%, p = 0.09). A subset analysis of tumors located specifically in eloquent brain demonstrated SGR to be as safe as PMR. CONCLUSIONS The authors describe the SGR technique used to resect LGGs and show that SGR is independently associated with statistically significantly higher rates of complete resection, without an increase in neurological complications, than with PMR. SGR technique should be considered when resecting LGGs.

Incidental Low-Grade Gliomas: Single-Institution Management Based on Clinical, Surgical, and Molecular Data

Neurosurgery ◽  
2019 ◽  
Author(s):  
Tamara Ius ◽  
Daniela Cesselli ◽  
Miriam Isola ◽  
Giada Pauletto ◽  
Barbara Tomasino ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Dna Methyltransferase ◽  
Tumor Volume ◽  
Extent Of Resection ◽  
Tumor Location ◽  
Molecular Profile ◽  
Karnofsky Performance Scale ◽  
Low Grade ◽  
Extensive Resection ◽  
Low Grade Gliomas

Abstract BACKGROUND Incidentally discovered diffuse low-grade gliomas (iLGG) are poorly documented in the literature. They are diagnosed by chance during radiological examinations. OBJECTIVE To review a cohort of patients with iLGG surgically treated in our institution, analyzing clinical, molecular, and surgical aspects. METHODS Clinical, radiological, and treatment data of iLGG were retrieved and compared with those of symptomatic diffuse LGGs (sLGG). Histological and molecular review was carried out as well. The extent of resection was evaluated on preoperative and postoperative T2-weighted magnetic resonance imaging. RESULTS Thirty-four iLGG cases were identified within a monoinstitutional cohort of 332 patients operated for low-grade gliomas from 2000 to 2017. Clinically, patients with iLGG had higher preoperative karnofsky performance scale (KPS) (P = .003), smaller tumor volume (P = .0001), lower frequency of eloquent areas involvement (P = .0001), and higher rate of complete resection (P = .0001) compared to those with sLGG. No differences in the molecular profile and O6-methylguanine-DNA-methyltransferase promoter methylation were detected between iLGG and sLGG. Importantly, patients with iLGG had longer overall survival than those with sLGG (P = .0001), even when a complete surgical resection was achieved (P = .001). CONCLUSION Although the therapeutic strategy of iLGG is still a matter of debate, our data support the safety and the effectiveness of early surgical resection. The favorable prognosis of iLGG may be due to the higher practicability of extensive resection, noneloquent tumor location, and smaller tumor volume.

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