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01-07-2017 | Original Article

Distant recurrences limit the survival of patients with thalamic high-grade gliomas after successful resection

Authors: Ryuta Saito, Toshihiro Kumabe, Masayuki Kanamori, Yukihiko Sonoda, Teiji Tominaga

Published in: Neurosurgical Review | Issue 3/2017

Abstract

The indications of surgery for thalamic high-grade gliomas are not well established. The present study investigated the outcome of 21 patients treated by surgery and reports the high incidence of distant recurrences including disseminations after successful removal. Twenty-one patients with thalamic high-grade gliomas not invading the pyramidal tract or midbrain underwent cytoreductive surgery at our institute from June 1997 to August 2015. Surgery was performed with the aid of a neuronavigation system, electrophysiological monitoring, and fluorescence navigation. Tumor histology included 12 cases of the World Health Organization grade III and nine cases of grade IV. Gross total resection was achieved in six cases, subtotal in 13, and partial in two. Motor weakness accompanied by sensory disturbance deteriorated immediately after surgery in 13 patients. However, five patients were determined to show deterioration at 2 months after surgery. Postoperative radiation and chemotherapy were given to every patient, and median progression-free survival of patients with grade III and IV tumors was 12.1 and 7.0 months, respectively. Median overall survival of patients with grade III and IV tumors was 25.6 and 12.6 months, respectively. High incidence of distant recurrences was found, with distant lesions at recurrence in 13 of 19 patients with recurrence, suggesting the life-restricting factor in these patients. Thalamic high-grade glioma without invasion into the pyramidal tract and brainstem can be considered as a candidate for surgical resection. Distant lesion limits the survival of patients after successful resection.

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Title: Distant recurrences limit the survival of patients with thalamic high-grade gliomas after successful resection
Authors: Ryuta Saito
Toshihiro Kumabe
Masayuki Kanamori
Yukihiko Sonoda
Teiji Tominaga
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: Neurosurgical Review / Issue 3/2017
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-016-0804-x

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Distant recurrences limit the survival of patients with thalamic high-grade gliomas after successful resection

Abstract

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