Comparative volumetric analysis of the extent of resection of molecularly and histologically distinct low grade gliomas and its role on survival

The authors investigate the role of extent of resection (EOR) and genetic markers on patient outcome and survival for LGGs. We conducted a retrospective cohort between 2005 and 2015, of 109 adult patients who underwent surgery for a LGG by a single surgeon. Volumetric computations of MRI studies wer...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of neuro-oncology 2017-08, Vol.134 (1), p.65-74
Main Authors:	Eseonu, Chikezie I., Eguia, Francisco, ReFaey, Karim, Garcia, Oscar, Rodriguez, Fausto J., Chaichana, Kaisorn, Quinones-Hinojosa, Alfredo
Format:	Article
Language:	eng
Subjects:	Adult Age Factors Aged Brain Neoplasms - diagnostic imaging Brain Neoplasms - genetics Brain Neoplasms - pathology Brain Neoplasms - surgery Chromosome Deletion Clinical Study Disease-Free Survival Female Genetic markers Glioma - diagnostic imaging Glioma - genetics Glioma - pathology Glioma - surgery Humans Isocitrate Dehydrogenase - genetics Kaplan-Meier Estimate Magnetic Resonance Imaging Male Medicine Medicine & Public Health Middle Aged Neurological diseases Neurology Neurosurgical Procedures - methods Oncology p53 Protein Proportional Hazards Models Retrospective Studies Surgery Survival Treatment Outcome Tumor Suppressor Protein p53 - genetics Volumetric analysis Young Adult
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	The authors investigate the role of extent of resection (EOR) and genetic markers on patient outcome and survival for LGGs. We conducted a retrospective cohort between 2005 and 2015, of 109 adult patients who underwent surgery for a LGG by a single surgeon. Volumetric computations of MRI studies were conducted to evaluate the EOR, and genetic markers (IDH1, 1p/19q co-deletion, and p53) were assessed and their effects on survival and neurological outcome were evaluated. The median EOR was 88.1%. Permanent postoperative neurological deficits were seen in 4.6% of patients. EOR was a significant predictor for both overall survival (OS) (hazard ratio [HR] = 0.979, 95% CI 0.961–0.980, p = 0.029) and progression free survival (PFS) (HR = 0.982, 95% CI 0.968–0.997, p = 0.018). Malignant progression free survival (MPFS) was predicted by the 1p/19q co-deletion (HR = 0.148, 95% CI 0.019–1.148, p = 0.048). Patients with EOR of 100% had a significantly better OS than EOR less than 90% (p = 0.038). Patients with an EOR of at least 76% had a better OS than EOR less than 76% (p = 0.025). Patients with an EOR of at least 71% had a better PFS than EOR less than 71% (p = 0.030). Preoperative tumor volume was found to have significant association with EOR (R 2 = 0.049, p = 0.031). Increased EOR is associated with improved OS and PFS survival outcomes, while 1p/19q co-deletion provides improved MPFS. Understanding both surgical resections and molecular markers of the tumor are important for effective management of LGG patients.
ISSN:	0167-594X 1573-7373