HOUT-33. FUNCTIONAL OUTCOME OF GLIOMA SURGERY UNDER AWAKE CONDITION AIMED FOR PRESERVATION OF SEVERAL FUNCTIONAL DOMAINS

Abstract Background Awake surgery for the eloquent cortex is a common strategy for glioma surgery. Although a recent emphasis has been placed on awake surgery both for dominant and nondominant cerebral hemispheres to preserve neurological/neuropsychological functions, those functional outcomes are not well investigated because few studies have focused on the longitudinal recovery process. This study explored the outcome of neurological/neuropsychological functions following awake surgery until the chronic phase. Methods A total of 87 patients with glioma who underwent awake surgery were included, and of these 66 patients matched our inclusion criteria. Each patient was assessed for neurological/neuropsychological functions before surgery, as well as acute and chronic phase. Additionally, scores for the KPS were collected. Results Almost all functions recovered within 3 months postoperatively, even when transient deficits were observed in the acute phase; however, deep sensory perception deficits and visuospatial cognitive disorders persisted into the chronic phase (15.4% of patients with parietal lesions, 14.3% of patients with right cerebral hemispheric lesion, respectively). KPS score ≥90 was achieved in 86.0% of patients with lower-grade glioma, whereas only 52.2% of glioblastoma patients scored ≥90. Primary causes of declined KPS were disorder of visuospatial cognition, sensorimotor function including deep sensation, aphasia, and emotional function. Conclusions Awake surgery leads to good functional outcome at the chronic phase of neurological/neuropsychological functions, except for deep sensory and visuospatial cognition. Because sensation and visuospatial cognitive disorder have major impacts on patients’ independence level, further importance should be placed on preserving these functions during surgery.

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High-field intraoperative MRI in glioma surgery: A prospective study with volumetric analysis of extent of resection and functional outcome

Neurochirurgie ◽

10.1016/j.neuchi.2018.02.003 ◽

2018 ◽

Vol 64 (3) ◽

pp. 155-160 ◽

Cited By ~ 4

Author(s):

H.-A. Leroy ◽

C. Delmaire ◽

E. Le Rhun ◽

E. Drumez ◽

J.-P. Lejeune ◽

...

Keyword(s):

Prospective Study ◽

Functional Outcome ◽

High Field ◽

Extent Of Resection ◽

Volumetric Analysis ◽

Intraoperative Mri ◽

Glioma Surgery ◽

A Prospective Study

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NCOG-41. FUNCTIONAL OUTCOME FOLLOWING NON-DOMINANT HEMISPHERIC GLIOMA SURGERY FROM THE ASPECT OF INDEPENDENCE LEVEL, COGNITIVE FUNCTION AND RETURN TO SOCIAL LIVES

Neuro-Oncology ◽

10.1093/neuonc/noaa215.579 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii138-ii138

Author(s):

Riho Nakajima ◽

Masashi Kinoshita ◽

Hirokazu Okita ◽

Mitsutoshi Nakada

Keyword(s):

Cognitive Function ◽

Functional Outcome ◽

Karnofsky Performance Status ◽

Performance Status ◽

Chronic Phase ◽

University Hospital ◽

Glioma Surgery ◽

Who Grade ◽

Social Lives ◽

Grade Ii

Abstract BACKGROUND Functional outcome has been paid much attention in surgery for eloquent area or dominant hemisphere. Little is known about functional outcome following surgery for non-dominant hemispheric gliomas, although some resent reports revealed the importance of right cerebral hemisphere on glioma surgery. Here, we investigated functional outcome of right cerebral hemispheric gliomas from the aspect of independence level, cognitive function, and return to social lives. METHODS Totally 82 patients with right cerebral hemispheric gliomas who underwent surgery for resection in Kanazawa university hospital were studied. Patients were divided into two groups, WHO grade II/III and IV. Karnofsky Performance Status (KPS), Mini-mental state examination (MMSE), and whether or not to return to work at pre-operation and chronic phase were evaluated. To reveal responsible region for decline of each index, the voxel-based lesion symptom (VLSM) analyses were performed. RESULTS MMSE; no difference was found through postoperative course in grade II/III, whereas postoperative score of grade IV was declined significantly compared with pre-operation (25.1 and 21.9 point; p=0.048). KPS; preoperative independence level was maintained until chronic phase in grade II/III (94.7 and 89.5). While, in grade IV, postoperative KPS was declined significantly than that of pre-operation (82.0 and 70.0, p=0.007). Results of the VLSM analysis revealed that patients who resected temporo-parietal junction in grade IV showed significantly low KPS score. Return to social lives; Reintegration ratio of working population was 71% and 35% for grade II/III and IV, respectively. Of these, as for grade II/III gliomas, the cingulate cortex and medial orbito-frontal cortex relate to return to social lives. CONCLUSIONS Functional outcome following surgery depends on tumor grade and resected region in right cerebral hemispheric gliomas.

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