Acta Neurochirurgica

, 151:427

Re-operation is a safe and effective therapeutic strategy in recurrent WHO grade II gliomas within eloquent areas

  • Juan Martino
  • Luc Taillandier
  • Sylvie Moritz-Gasser
  • Peggy Gatignol
  • Hugues Duffau
Clinical Article

DOI: 10.1007/s00701-009-0232-6

Cite this article as:
Martino, J., Taillandier, L., Moritz-Gasser, S. et al. Acta Neurochir (2009) 151: 427. doi:10.1007/s00701-009-0232-6

Abstract

Background

To analyze the functional and oncological results after re-operation for recurrent WHO grade II Glioma located in eloquent regions.

Method

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.

Findings

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.

Conclusions

Repeat operations guided by intra-operative electrical stimulation is an efficacious treatment for recurrent grade II glioma in an eloquent area.

Keywords

Brain plasticityIntraoperative electrical stimulationLow-grade gliomaOperationTumour recurrence

Abbreviations

GIIG

World Health Organization grade II glioma

IES

intraoperative electrical stimulation

MRI

magnetic resonance imaging

PET

positron emission tomography

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Juan Martino
    • 1
  • Luc Taillandier
    • 2
  • Sylvie Moritz-Gasser
    • 3
  • Peggy Gatignol
    • 4
  • Hugues Duffau
    • 4
    • 5
  1. 1.Department of NeurosurgeryHospital Universitario Marqués de ValdecillaCantabriaSpain
  2. 2.Department of NeurologyCHU NancyNancyFrance
  3. 3.Department of NeurologyHôpital Gui de ChauliacMontpellierFrance
  4. 4.Laboratoire de Psychologie et de Neurosciences CognitivesUMR 8189 (CNRS/ Université de Paris V René Descartes), Institut de PsychologieBoulogne BillancourtFrance
  5. 5.Department of NeurosurgeryHôpital Gui de Chauliac, CHU de MontpellierMontpellierFrance