Long-term outcome and survival of surgically treated supratentorial low-grade glioma in adult patients
The appropriate management of low-grade gliomas is still a matter of debate. So far, there are no randomized studies that analyze the impact of surgical resection on patient outcome. The value of the data obtained from the few retrospective reports available is often limited.
Patients and methods
In the present study, we performed an analysis on data of 130 adult low-grade glioma patients. Extent of the resection was evaluated in correlation to the overall survival (OS) and progression-free survival (PFS) using Cox regression multivariate analysis.
Extended surgery was shown to prolong OS and PFS significantly. Re-surgery in the case of a tumor relapse has a significant impact on OS and PFS, too.
In summary, we could retrospectively evaluate a large case series of well-defined low-grade gliomas patients with a long follow-up period showing that extended surgery would be the most effective therapy for low-grade glioma patients even in recurrent diseases.
KeywordsLow-grade glioma Extent of surgery Survival
- 1.Albert FK, Forsting M, Sartor K, Adams HP, Kunze S (1994) Early postoperative magnetic resonance imaging after resection of malignant glioma: objective evaluation of residual tumor and its influence on regrowth and prognosis. Neurosurgery 34:45–60. doi: 10.1097/00006123-199401000-00008 CrossRefPubMedGoogle Scholar
- 3.Duffau H, Lopes M, Arthuis F, Bitar A, Sichez JP, Van Effenterre R, Capelle L (2005) Contribution of intraoperative electrical stimulations in surgery of low-grade gliomas: Contribution of intraoperative electrical stimulations in surgery of low-grade gliomas: a comparative study between two series without (1985–96) and with (1996–2003) functional mapping in the same institution. J Neurol Neurosurg Psychiatry 76:845–851. doi: 10.1136/jnnp. 2004.048520 CrossRefPubMedGoogle Scholar
- 4.Eyre HJ, Crowley JJ, Townsend JJ, Eltringham JR, Morantz RA, Schulman SF, Quagliana JM, al-Sarraf M (1993) A randomized trial of radiotherapy versus radiotherapy plus CCNU for incompletely resected low-grade gliomas: a Southwest Oncology Group study. J Neurosurg 78:909–914CrossRefPubMedGoogle Scholar
- 8.Karim AB, Afra D, Cornu P, Bleehan N, Schraub S, De Witte O, Darcel F, Stenning S, Pierart M, Van Glabbecke M (2002) Randomized trial on the efficacy of radiotherapy for cerebral low-grade glioma in the adult: European Organisation for Research and Treatment of Cancer Study 22845 with the Medical Research Council study BR04: an interim analysis. Int J Radiat Oncol Biol Phys 52:316–324. doi: 10.1016/S0360-3016(01)02692-X PubMedGoogle Scholar
- 14.Okamoto Y, Di Patre PL, Burkhard C, Horstmann S, Jourde B, Fahey M, Schüler D, Probst-Hensch NM, Yasargil MG, Yonekawa Y, Lütolf UM, Kleihues P, Ohgaki H (2994) Population-based study on incidence, survival rates, and genetic alterations of low-grade diffuse astrocytomas and oligodendrogliomas. Acta Neuropathol 108:327–335Google Scholar
- 18.Pignatti F, van den Bent M, Curran D, Debruyne CH, Sylvester R, Therasse P, Afra D, Cornu PH, Bolla M, Vecht CH, Karim A, for the EORTC Brain tumor cooperative group and radiotherapy cooperative group (2002) Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol 20:2076–2084. doi: 10.1200/JCO.2002.08.121 CrossRefPubMedGoogle Scholar
- 23.Soffietti R, Chio A, Giordana MT, Vasario E, Schiffer D (1990) Prognostic factors in well-differentiated cerebral astrocytomas in the adult. Neurosurgery 26:359–360Google Scholar
- 24.Talos IF, Zou KH, Ohno-Machado L, Bhagwat JG, Kikinis R, Black PM, Jolesz FA (2006) Supratentorial low-grade glioma respectability: statistical predictive analysis based on anatomic MR features and tumor characteristics. Radiology 239:506–513. doi: 10.1148/radiol.2392050661 CrossRefPubMedGoogle Scholar
- 25.Van den Bent MJ, Afra D, de Witte O, Ben Hassel M, Schraub S, Haang Xuan K, Malmström P-O, Collette L, Piérart M, Mirimanoff R, Karim ABMF, EORTC Radiotherapy and Brain Tumor Groups and the UK Medical Research Council (2005) Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trials. Lancet 366:985–990. doi: 10.1016/S0140-6736(05)67070-5 CrossRefPubMedGoogle Scholar