Re-operation is a safe and effective therapeutic strategy in recurrent WHO grade II gliomas within eloquent areas
- Juan MartinoAffiliated withDepartment of Neurosurgery, Hospital Universitario Marqués de Valdecilla
- , Luc TaillandierAffiliated withDepartment of Neurology, CHU Nancy
- , Sylvie Moritz-GasserAffiliated withDepartment of Neurology, Hôpital Gui de Chauliac
- , Peggy GatignolAffiliated withLaboratoire de Psychologie et de Neurosciences Cognitives, UMR 8189 (CNRS/ Université de Paris V René Descartes), Institut de Psychologie
- , Hugues DuffauAffiliated withLaboratoire de Psychologie et de Neurosciences Cognitives, UMR 8189 (CNRS/ Université de Paris V René Descartes), Institut de PsychologieDepartment of Neurosurgery, Hôpital Gui de Chauliac, CHU de Montpellier Email author
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To analyze the functional and oncological results after re-operation for recurrent WHO grade II Glioma located in eloquent regions.
We reviewed a consecutive series of 19 patients with GIIG within functional areas who underwent two operations separated by at least 1 year. Intraoperative electrical stimulation mapping was used in all operations for recurrence and in 14 of the initial procedures. A specific rehabilitation was provided.
At the first operation, we performed 14 subtotal and 5 partial resections. Eighteen patients returned to a normal socio-professional life. Nine patients received adjuvant treatment. At the second operation, we performed 1 total, 13 subtotal and 5 partial resections. Three patients with a preoperative neurological deficit improved, 13 remained unchanged, and 3 slight new deficits appeared. In 14 of the 17 patients with preoperative chronic epilepsy, the seizures were reduced or disappeared. Sixteen patients returned to a normal socio-professional life. Pathohistological examination showed that 11 tumours had progressed to high-grade glioma. The median time between the two operations was 4.1 years (range 1 to 7.8 years) and the median follow-up from initial diagnosis was 6.6 years (range 2.3 to 14.3 years). No deaths occurred during the follow-up period.
Repeat operations guided by intra-operative electrical stimulation is an efficacious treatment for recurrent grade II glioma in an eloquent area.
KeywordsBrain plasticity Intraoperative electrical stimulation Low-grade glioma Operation Tumour recurrence
- Re-operation is a safe and effective therapeutic strategy in recurrent WHO grade II gliomas within eloquent areas
Volume 151, Issue 5 , pp 427-436
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- Springer Vienna
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- Brain plasticity
- Intraoperative electrical stimulation
- Low-grade glioma
- Tumour recurrence
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- Author Affiliations
- 1. Department of Neurosurgery, Hospital Universitario Marqués de Valdecilla, Av de Valdecilla s/n, Santander, Cantabria, Spain
- 2. Department of Neurology, CHU Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France
- 3. Department of Neurology, Hôpital Gui de Chauliac, CHU Montpellier, 80 Av Augustin Fliche, 34295, Montpellier, France
- 4. Laboratoire de Psychologie et de Neurosciences Cognitives, UMR 8189 (CNRS/ Université de Paris V René Descartes), Institut de Psychologie, 71 avenue Edouard Vaillant, 92774, Boulogne Billancourt, France
- 5. Department of Neurosurgery, Hôpital Gui de Chauliac, CHU de Montpellier, 80 avenue Augustin Fliche, 34295, Montpellier, France