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Published in: Journal of Neuro-Oncology 1/2017

Open Access 01-05-2017 | Clinical Study

Does early resection of presumed low-grade glioma improve survival? A clinical perspective

Authors: Maarten M. J. Wijnenga, Tariq Mattni, Pim J. French, Geert-Jan Rutten, Sieger Leenstra, Fred Kloet, Martin J. B. Taphoorn, Martin J. van den Bent, Clemens M. F. Dirven, Marie-Lise van Veelen, Arnaud J. P. E. Vincent

Published in: Journal of Neuro-Oncology | Issue 1/2017

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Abstract

Early resection is standard of care for presumed low-grade gliomas. This is based on studies including only tumors that were post-surgically confirmed as low-grade glioma. Unfortunately this does not represent the clinicians’ situation wherein he/she has to deal with a lesion on MRI that is suspect for low-grade glioma (i.e. without prior knowledge on the histological diagnosis). We therefore aimed to determine the optimal initial strategy for patients with a lesion suspect for low-grade glioma, but not histologically proven yet. We retrospectively identified 150 patients with a resectable presumed low-grade-glioma and who were otherwise in good clinical condition. In this cohort we compared overall survival between three types of initital treatment strategy: a wait-and-scan approach (n = 38), early resection (n = 83), or biopsy for histopathological verification (n = 29). In multivariate analysis, no difference was observed in overall survival for early resection compared to wait-and-scan: hazard ratio of 0.92 (95% CI 0.43–2.01; p = 0.85). However, biopsy strategy showed a shorter overall survival compared to wait-and-scan: hazard ratio of 2.69 (95% CI 1.19–6.06; p = 0.02). In this cohort we failed to confirm superiority of early resection over a wait-and-scan approach in terms of overall survival, though longer follow-up is required for final conclusion. Biopsy was associated with shorter overall survival.
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Metadata
Title
Does early resection of presumed low-grade glioma improve survival? A clinical perspective
Authors
Maarten M. J. Wijnenga
Tariq Mattni
Pim J. French
Geert-Jan Rutten
Sieger Leenstra
Fred Kloet
Martin J. B. Taphoorn
Martin J. van den Bent
Clemens M. F. Dirven
Marie-Lise van Veelen
Arnaud J. P. E. Vincent
Publication date
01-05-2017
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 1/2017
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-017-2418-8

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