1. The benefit of early surgery on overall survival in incidental low-grade glioma patients: A multicenter study
- Author
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John Kelly, David Ben-Israel, Miran Skrap, Hugues Duffau, Jacob S. Young, Barbara Tomasino, Mitchel S. Berger, Tamara Ius, Maurizio Polano, Sam Ng, Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Università degli Studi di Udine - University of Udine [Italie], Neurochirurgie [Hôpital Gui de Chauliac], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), University of California [San Francisco] (UCSF), University of California, IRCCS Eugenio Medea, IRCCS, University of Calgary, Service de Neurochirurgie [Montpellier], and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Gui de Chauliac [Montpellier]
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Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,[SDV]Life Sciences [q-bio] ,Population ,Clinical Investigations ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Fluid-attenuated inversion recovery ,Neurosurgical Procedures ,03 medical and health sciences ,Early surgery ,0302 clinical medicine ,Overall survival ,Humans ,Medicine ,Extension of Resection ,education ,Retrospective Studies ,High-Grade Glioma ,Brain Mapping ,education.field_of_study ,Brain Neoplasms ,business.industry ,Glioma ,Molecular pattern ,Incidental findings ,Treatment Outcome ,Low Grade Gliomas ,Oncology ,Multicenter study ,030220 oncology & carcinogenesis ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Low-Grade Glioma ,Neurology (clinical) ,Radiology ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,030217 neurology & neurosurgery - Abstract
Background The role of surgery for incidentally discovered diffuse incidental low-grade gliomas (iLGGs) is debatable and poorly documented in current literature. Objective The aim was to identify factors that influence survival for patients that underwent surgical resection of iLGGs in a large multicenter population. Methods Clinical, radiological, and surgical data were retrospectively analyzed in 267 patients operated for iLGG from 4 neurosurgical Centers. Univariate and multivariate analyses were performed to identify predictors of overall survival (OS) and tumor recurrence (TR). Results The OS rate was 92.41%. The 5- and 10-year estimated OS rates were 98.09% and 93.2%, respectively. OS was significantly longer for patients with a lower preoperative tumor volume (P = .001) and higher extent of resection (EOR) (P = .037), regardless the WHO-defined molecular class (P = .2). In the final model, OS was influenced only by the preoperative tumor volume (P = .006), while TR by early surgery (P = .028). A negative association was found between preoperative tumor volumes and EOR (rs = −0.44, P < .001). The median preoperative tumor volume was 15 cm3. The median EOR was 95%. Total or supratotal resection of T2-FLAIR abnormality was achieved in 61.62% of cases. Second surgery was performed in 26.22%. The median time between surgeries was 5.5 years. Histological evolution to high-grade glioma was detected in 22.85% of cases (16/70). Permanent mild deficits were observed in 3.08% of cases. Conclusions This multicenter study confirms the results of previous studies investigating surgical management of iLGGs and thereby strengthens the evidence in favor of early surgery for these lesions.
- Published
- 2021
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