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From Management of Incidental DLGG to Screening of Silent DLGG

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Diffuse Low-Grade Gliomas in Adults

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Abstract

As access to brain MRI is getting wider, it is not uncommon to diagnose incidentally a diffuse low-grade glioma (DLGG) in a neurologically fully asymptomatic patient. Based on the results of maximal safe surgical resection in symptomatic patients—allowing to significantly increase overall survival while preserving quality of life by sparing the cerebral connectome—surgery under local anesthesia with intensive cognitive monitoring and mapping has recently been proposed in incidental DLGG patients. First results showed that, by performing earlier surgery, that is, for smaller tumors, extent of resection was maximized and risk of malignant transformation was minimized, while patients continued to have a normal familial, social and professional life—especially with no epilepsy. As a consequence, it was proposed to set up a policy of screening in the population between 20 and 40 years-old, by offering to healthy volunteers a cerebral MRI. We analyzed the conceptual and practical elements of feasibility, and conclude that benefits would overweight the costs and risks of such a strategy.

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Authors and Affiliations

  1. Department of Neurosurgery, Lariboisière Hospital, 2 Rue Ambroise Paré, 75010, Paris, France

    Emmanuel Mandonnet

  2. IMNC, UMR 8165, 91405, Orsay, France

    Emmanuel Mandonnet

  3. Department of Neurology, CHU Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France

    Luc Taillandier

  4. Department of Neurosurgery, Gui de Chauliac Hospital, CHU Montpellier, Montpellier University Medical Center, 80, Avenue Augustin Fliche, 34295, Montpellier, France

    Hugues Duffau MD, PhD

  5. Institute for Neurosciences of Montpellier, INSERM U1051, Team “Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors,” Saint Eloi Hospital, Montpellier University Medical Center, Montpellier, France

    Hugues Duffau MD, PhD

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  1. Emmanuel Mandonnet
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  3. Hugues Duffau MD, PhD
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Correspondence to Emmanuel Mandonnet .

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Editors and Affiliations

  1. Department of Neurosurgery, Montpellier University Medical Center, INSERM U1051, Institute for Neurosciences of Montpellier, Montpellier, France

    Hugues Duffau

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Mandonnet, E., Taillandier, L., Duffau, H. (2017). From Management of Incidental DLGG to Screening of Silent DLGG. In: Duffau, H. (eds) Diffuse Low-Grade Gliomas in Adults. Springer, Cham. https://doi.org/10.1007/978-3-319-55466-2_35

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  • DOI: https://doi.org/10.1007/978-3-319-55466-2_35

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-55464-8

  • Online ISBN: 978-3-319-55466-2

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