scholarly journals High Grade Glioma Surgery - Clinical Aspects and Prognosis

Folia Medica ◽  
2021 ◽  
Vol 63 (1) ◽  
pp. 35-41
Author(s):  
Milan Mladenovsk ◽  
Iliya Valkov ◽  
Mladen Ovcharov ◽  
Nikolay Vasilev ◽  
Iliya Duhlenski
Keyword(s):  
Median Survival ◽  
Neurological Deficit ◽  
High Grade Glioma ◽  
Tumour Volume ◽  
Survival Period ◽  
Clinical Aspects ◽  
Temporal Region ◽  
High Grade ◽  
Glioma Surgery ◽  
Tumor Survival

Introduction: High grade gliomas (HGG) are a group of tumors with infiltrative nature in general. Surgery is the first step in their treatment. It can be beneficial in two aspects: firstly, in establishing normal intracranial pressure and, secondly, in reducing the tumour volume. The choice of method depends on the location of the lesion, the expected grade of malignancy, and the general condition of the patient. Despite constant development of neuro-oncology and microsurgical techniques, the 5-year survival rate in patients with HGG remains less than 10% and the median survival is still less than 2 years.&nbsp; Aim: At present, there is no final therapeutic &ldquo;segment&rdquo; to provide a better outcome than the complex treatment of HGG. Moreover, the treatment&rsquo;s relative efficacy and recurrence of these tumours carry an additional problem. The aim of this study was to estimate the overall survival of patients with HGG operated in our clinic and compare it with literature data.&nbsp; Materials and methods: One hundred twenty-one cranial operations for HGG were reviewed (conducted between 2014 and 2019). Summary characteristics of the various parameters were presented in respect to the radical nature of the operative intervention using Kaplan-Meier analysis and chi square tests. All patients were followed up at regular check-ups. Results: HGGs were 103 or 85.12% of all gliomas operated for the 2014-2019 period. The most common cases were in the 51 to 60 age group. The cases in men were twice as common. The most common localization of the neoplasm is in the temporal region (36.36%) and the rarest was found in the occipital region (3.30%). It was estimated that our operated patients with HGG had 12.23 months over-all survival. Gross total resected patients had a median survival (OS) of 14.53 months, while subtotal resected patients had a median survival (OS) of 10.44 months. It is estimated 7.97 months free tumor survival period (time to relapse - FTS) for our operated patients with HGG. Gross total resected patients had a median FTS of 10.88 months, while subtotal resected patients had median FTS of 5.70 months. We noticed permanent new neurological deficit (NND) in 20 patients (19.45%) operated with GTR, and in 5 patients (4.85%) operated with STR.&nbsp; Conclusions: Median survival - OS, free tumor survival period - FTS and new neurological deficit - NND were statistically significant (p<0.05) with extent of resection &ndash; GTR or STR in our study. Maximal safe radical (total) or supratotal resection is preferred in treating HGG.&nbsp;

scholarly journals How well do neurosurgeons predict survival in patients with high-grade glioma?

2021 ◽  
Author(s):  
Lisa Millgård Sagberg ◽  
Asgeir S. Jakola ◽  
Ingerid Reinertsen ◽  
Ole Solheim
Keyword(s):  
Median Survival ◽  
Survival Curve ◽  
Binary Logistic Regression ◽  
High Grade Glioma ◽  
Accurate Estimation ◽  
Binary Logistic Regression Analysis ◽  
High Grade ◽  
Clinical Prediction ◽  
Individual Level ◽  
Actual Survival

AbstractDue to the lack of reliable prognostic tools, prognostication and surgical decisions largely rely on the neurosurgeons’ clinical prediction skills. The aim of this study was to assess the accuracy of neurosurgeons’ prediction of survival in patients with high-grade glioma and explore factors possibly associated with accurate predictions. In a prospective single-center study, 199 patients who underwent surgery for high-grade glioma were included. After surgery, the operating surgeon predicted the patient’s survival using an ordinal prediction scale. A survival curve was used to visualize actual survival in groups based on this scale, and the accuracy of clinical prediction was assessed by comparing predicted and actual survival. To investigate factors possibly associated with accurate estimation, a binary logistic regression analysis was performed. The surgeons were able to differentiate between patients with different lengths of survival, and median survival fell within the predicted range in all groups with predicted survival < 24 months. In the group with predicted survival > 24 months, median survival was shorter than predicted. The overall accuracy of surgeons’ survival estimates was 41%, and over- and underestimations were done in 34% and 26%, respectively. Consultants were 3.4 times more likely to accurately predict survival compared to residents (p = 0.006). Our findings demonstrate that although especially experienced neurosurgeons have rather good predictive abilities when estimating survival in patients with high-grade glioma on the group level, they often miss on the individual level. Future prognostic tools should aim to beat the presented clinical prediction skills.

scholarly journals Impact of intraoperative stimulation mapping on high-grade glioma surgery outcome: a meta-analysis

2018 ◽  
Vol 161 (1) ◽  
pp. 99-107 ◽  
Author(s):  
Jasper Kees Wim Gerritsen ◽  
Lidia Arends ◽  
Markus Klimek ◽  
Clemens Maria Franciscus Dirven ◽  
Arnaud Jean-Pierre Edouard Vincent
Keyword(s):  
Meta Analysis ◽  
High Grade Glioma ◽  
High Grade ◽  
Glioma Surgery ◽  
Surgery Outcome

scholarly journals High-definition fiber tractography for the evaluation of perilesional white matter tracts in high-grade glioma surgery

2015 ◽  
pp. nov113 ◽  
Author(s):  
Kumar Abhinav ◽  
Fang-Cheng Yeh ◽  
Alireza Mansouri ◽  
Gelareh Zadeh ◽  
Juan C. Fernandez-Miranda
Keyword(s):  
White Matter ◽  
High Grade Glioma ◽  
High Grade ◽  
Fiber Tractography ◽  
High Definition ◽  
Glioma Surgery ◽  
White Matter Tracts

scholarly journals Contemporary intraoperative visualization for GBM with use of exoscope, 5-ALA fluorescence-guided surgery and tractography

2022 ◽  
Vol 6 (1) ◽  
pp. V5
Keyword(s):  
Diffusion Tensor ◽  
High Grade Glioma ◽  
Brain Regions ◽  
High Grade ◽  
Glioma Surgery ◽  
Guided Surgery ◽  
Word Finding ◽  
Patient Consent ◽  
Dti Fiber Tracking ◽  
Intraoperative Visualization

Maximal safe resection is the primary goal of glioma surgery. By incorporating improved intraoperative visualization with the 3D exoscope combined with 5-ALA fluorescence, in addition to neuronavigation and diffusion tensor imaging (DTI) fiber tracking, the safety of resection of tumors in eloquent brain regions can be maximized. This video highlights some of the various intraoperative adjuncts used in brain tumor surgery for high-grade glioma. In this case, the authors highlight the resection of a left posterior temporal lobe high-grade glioma in a 33-year-old patient, who initially presented with seizures, word-finding difficulty, and right-sided weakness. They demonstrate the multiple surgical adjuncts used both before and during surgical resection, and how multiple adjuncts can be effectively orchestrated to make surgery in eloquent brain areas safer for patients. Patient consent was obtained for publication. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21174

scholarly journals SURG-05. NAVIGATED INTRA-OPERATIVE 2-D ULTRASOUND VS STANDARD NEURONAVIGATION IN HIGH GRADE GLIOMA SURGERY

2018 ◽  
Vol 20 (suppl_6) ◽  
pp. vi251-vi251
Author(s):  
Alessandro Moiraghi ◽  
Francesco Prada ◽  
Alberto Delaidelli ◽  
Cristina Goga ◽  
Ramona Guatta ◽  
...  
Keyword(s):  
High Grade Glioma ◽  
High Grade ◽  
Glioma Surgery

scholarly journals Navigated Intraoperative 2-Dimensional Ultrasound in High-Grade Glioma Surgery: Impact on Extent of Resection and Patient Outcome

2019 ◽  
Author(s):  
Alessandro Moiraghi ◽  
Francesco Prada ◽  
Alberto Delaidelli ◽  
Ramona Guatta ◽  
Adrien May ◽  
...  
Keyword(s):  
Real Time ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Intraoperative Ultrasound ◽  
High Grade Glioma ◽  
Extent Of Resection ◽  
High Grade ◽  
Glioma Surgery ◽  
Supratentorial Gliomas ◽  
The Impact

Abstract BACKGROUND Maximizing extent of resection (EOR) and reducing residual tumor volume (RTV) while preserving neurological functions is the main goal in the surgical treatment of gliomas. Navigated intraoperative ultrasound (N-ioUS) combining the advantages of ultrasound and conventional neuronavigation (NN) allows for overcoming the limitations of the latter. OBJECTIVE To evaluate the impact of real-time NN combining ioUS and preoperative magnetic resonance imaging (MRI) on maximizing EOR in glioma surgery compared to standard NN. METHODS We retrospectively reviewed a series of 60 cases operated on for supratentorial gliomas: 31 operated under the guidance of N-ioUS and 29 resected with standard NN. Age, location of the tumor, pre- and postoperative Karnofsky Performance Status (KPS), EOR, RTV, and, if any, postoperative complications were evaluated. RESULTS The rate of gross total resection (GTR) in NN group was 44.8% vs 61.2% in N-ioUS group. The rate of RTV > 1 cm3 for glioblastomas was significantly lower for the N-ioUS group (P < .01). In 13/31 (42%), RTV was detected at the end of surgery with N-ioUS. In 8 of 13 cases, (25.8% of the cohort) surgeons continued with the operation until complete resection. Specificity was greater in N-ioUS (42% vs 31%) and negative predictive value (73% vs 54%). At discharge, the difference between pre- and postoperative KPS was significantly higher for the N-ioUS (P < .01). CONCLUSION The use of an N-ioUS-based real-time has been beneficial for resection in noneloquent high-grade glioma in terms of both EOR and neurological outcome, compared to standard NN. N-ioUS has proven usefulness in detecting RTV > 1 cm3.

scholarly journals Mindbomb Homolog-1 Index in the Prognosis of High-Grade Glioma and Its Clinicopathological Correlation

2019 ◽  
Vol 10 (02) ◽  
pp. 185-193
Author(s):  
Shyam Sundar Krishnan ◽  
Shanmugam Muthiah ◽  
Shilpa Rao ◽  
Suganthi Srinivasan Salem ◽  
Vasudevan Chakravarthy Madabhushi ◽  
...  
Keyword(s):  
Median Survival ◽  
High Grade Glioma ◽  
Tumor Grade ◽  
Bivariate Analysis ◽  
Karnofsky Performance Score ◽  
High Grade ◽  
Tissue Samples ◽  
Midline Crossing ◽  
Index Value ◽  
Mib 1

ABSTRACT Introduction: Gliomas are the most common brain tumors in adults originating from the glial cells. Glioblastoma multiforme is the most malignant and frequent among all gliomas. In recent years, the antibody Mindbomb Homolog-1 (MIB-1) has evolved as a measure of the proliferative nature of the glial tumors. This study aims to investigate the MIB-1 index value as an independent prognostic factor in high-grade gliomas and its correlation with outcome and survival. Materials and Methods: Mean MIB-1 index was determined in 51 high-grade glioma tissue samples in formalin. Its correlation with outcome by assessing the clinicoradiological parameters and median survival of patients in months were assessed. Survival analysis was studied by using the Kaplan–Meier bivariate analysis and Cox proportional ratio. Results: Preoperative Karnofsky Performance Score, WHO-PS, Neurological Performance Scale, and Mini–Mental Status Examination (MMSE) were statistically significant with respect to outcome and survival, whereas tumor factors such as size and perilesional edema were not. In particular, midline-crossing tumors and deep-seated tumors were significantly associated with high MIB-1 index and by correlation with outcome. There were significantly higher number (P < 0.0001) of patients with Grade IV tumors, with an MIB-1 index value above an arbitrary cutoff of 10% compared to Grade III tumors. In addition, median survival period of patients with low MIB-1 index was longer irrespective of tumor grade. Conclusion: Significant correlation between high-grade glioma and MIB-1 index suggests MIB-1 index to be a good prognostic tool, with MIB-1 index and midline-crossing variables being independent prognostic parameters.

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