Turkoglu Erhan, Gurer Bora, Sanli Ahmet M, Dolgun Habibullah, Gurses Levent, Oral Nezih A, Donmez Teoman, Sekerci Zeki
Neurosurgery Clinic, Ministry of Health, Diskapi Yildirim Beyazit Education and Research Hospital, 06100 Ankara, Turkey.
Clin Neurol Neurosurg. 2013 Dec;115(12):2508-13. doi: 10.1016/j.clineuro.2013.10.010. Epub 2013 Oct 25.
Low grade gliomas (LGGs) are slow-growing primary brain tumors with heterogeneous clinical behaviors. The aim of our study is to review the treatment outcome of 63 patients with LGGs focusing on surgical outcome and the current therapeutic strategy.
We retrospectively enrolled 63 patients surgically treated for LGGs. The gross total resection (GTR) was performed in 35 patients (60.3%), subtotal resection (STR) was performed in 19 patients (31.7%) and partial resection (PR) or biopsy was performed in 9 patients (14.3%). We analyzed their progression-free survival (PFS), overall survival (OS), and malignant transformation with regard to age, gender, Karnofsky performance score (KPS), clinical presentation, tumor location, radiologic pattern, contrast enhancement, extent of removal, pathologic subtype, chemotherapy (CT) and radiotherapy (RT) treatment.
Among all LGGs, the 3-year OS rate was 80% and the 5-year OS was 76%. The 3-year PFS rate was 83.6% and the 5-year PFS was 25%. The non-eloquent area location showed a longer PFS than the eloquent area location (p=0.05). Oligodendroglial pathology showed a longer PFS compared to oligoastrocytomas and astrocytomas (p=0.02). Patients older than 60 years had poorer OS than younger patients (p<0.05). Female gender had a shorter OS than male gender (p<0.05), and a KPS of 90 or 100 had a longer OS than a KPS of 80 (p<0.05). Oligodendroglial pathology statistically correlated with a longer OS (p<0.05).
The findings from our study, which were confirmed by uni- and multivariate analyses, demonstrated that radical tumor resection was associated with better long-term outcomes and tumor progression for patients with LGG.
低级别胶质瘤(LGGs)是生长缓慢的原发性脑肿瘤,具有异质性临床行为。我们研究的目的是回顾63例LGGs患者的治疗结果,重点关注手术结果和当前的治疗策略。
我们回顾性纳入了63例接受LGGs手术治疗的患者。35例患者(60.3%)进行了全切除(GTR),19例患者(31.7%)进行了次全切除(STR),9例患者(14.3%)进行了部分切除(PR)或活检。我们分析了他们的无进展生存期(PFS)、总生存期(OS)以及关于年龄、性别、卡诺夫斯基表现评分(KPS)、临床表现、肿瘤位置、放射学模式、增强情况、切除范围、病理亚型、化疗(CT)和放疗(RT)治疗的恶性转化情况。
在所有LGGs患者中,3年总生存率为80%,5年总生存率为76%。3年无进展生存率为83.6%,5年无进展生存率为25%。非语言区位置的无进展生存期比语言区位置更长(p = 0.05)。少突胶质细胞瘤病理类型的无进展生存期比少突星形细胞瘤和星形细胞瘤更长(p = 0.02)。60岁以上患者的总生存期比年轻患者差(p < 0.05)。女性的总生存期比男性短(p < 0.05),KPS为90或100的患者总生存期比KPS为80的患者长(p < 0.05)。少突胶质细胞瘤病理类型与更长的总生存期具有统计学相关性(p <
我们的研究结果经单因素和多因素分析证实,表明根治性肿瘤切除与LGGs患者更好的长期预后和肿瘤进展相关。