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Reoperations of patients with low-grade gliomas in eloquent or near eloquent brain areas
Affiliations- Katedra i Oddział Kliniczny Neurochirurgii w Sosnowcu, Śląski Uniwersytet Medyczny w Katowicach
- Zakład Radiodiagnostyki, Instytut Onkologii w Gliwicach
- Katedra i Klinika Neurologii Collegium Medicum, Uniwersytet Jagielloński w Krakowie
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Abstract
Reoperations of patients with recurrent low-grade gliomas (LGG) are not always recommended due to a higher risk of neurological deficits when compared to initial surgery. The purpose of the present study was to evaluate surgical outcomes of patients operated on for recurrent LGG.
Material and methodsSixteen patients who had surgery for recurrent LGG out of 68 LGG patients who underwent surgery at the Department of Neurosurgery in Sosnowiec, Poland between 2005 and 2011 were enrolled in the study.
ResultsA large tumour volume prior to the initial surgery was the most significant parameter influencing LGG progression (96.6 cm3 vs. 47.9 cm3, p = 0.01). Increased incidence of epileptic seizures and decreased mental ability according to Karnofsky score were the most common symptoms associated with tumour recurrence. In the group of patients with malignant transformation, the relative cerebral blood volume (rCBV) was considerably increased (1.21 vs. 2.41, p < 0.01). No statistically significant difference was found in terms of the extent of resection between initial surgery and reoperation. Similarly, no significant difference was found in the number of patients with a permanent neurological deficit after initial surgery and reoperation.
ConclusionsReoperations of the patients with recurrent LGG are not burdened with a higher risk of neurological sequelae when compared to initial surgery. The extent of resection during the surgery for LGG recurrence is comparable to initial surgery. The increase of rCBV seems to be a significant biomarker that indicates malignant transformation.
Abstract
Reoperations of patients with recurrent low-grade gliomas (LGG) are not always recommended due to a higher risk of neurological deficits when compared to initial surgery. The purpose of the present study was to evaluate surgical outcomes of patients operated on for recurrent LGG.
Material and methodsSixteen patients who had surgery for recurrent LGG out of 68 LGG patients who underwent surgery at the Department of Neurosurgery in Sosnowiec, Poland between 2005 and 2011 were enrolled in the study.
ResultsA large tumour volume prior to the initial surgery was the most significant parameter influencing LGG progression (96.6 cm3 vs. 47.9 cm3, p = 0.01). Increased incidence of epileptic seizures and decreased mental ability according to Karnofsky score were the most common symptoms associated with tumour recurrence. In the group of patients with malignant transformation, the relative cerebral blood volume (rCBV) was considerably increased (1.21 vs. 2.41, p < 0.01). No statistically significant difference was found in terms of the extent of resection between initial surgery and reoperation. Similarly, no significant difference was found in the number of patients with a permanent neurological deficit after initial surgery and reoperation.
ConclusionsReoperations of the patients with recurrent LGG are not burdened with a higher risk of neurological sequelae when compared to initial surgery. The extent of resection during the surgery for LGG recurrence is comparable to initial surgery. The increase of rCBV seems to be a significant biomarker that indicates malignant transformation.
Keywords
low-grade glioma, tumour progression, reoperation, relative cerebral blood volume
About this articleTitle
Reoperations of patients with low-grade gliomas in eloquent or near eloquent brain areas
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
116-125
Page views
369
Article views/downloads
346
DOI
10.5114/ninp.2013.34399
Bibliographic record
Neurol Neurochir Pol 2013;47(2):116-125.
Keywords
low-grade glioma
tumour progression
reoperation
relative cerebral blood volume
Authors
Wojciech Kaspera
Krzysztof Majchrzak
Barbara Bobek-Billewicz
Anna Hebda
Gabriela Stasik-Pres
Henryk Majchrzak
Piotr Ładziński
Agnieszka Machowska-Majchrzak
