Ius Tamara, Pauletto Giada, Cesselli Daniela, Isola Miriam, Turella Luca, Budai Riccardo, DeMaglio Giovanna, Eleopra Roberto, Fadiga Luciano, Lettieri Christian, Pizzolitto Stefano, Beltrami Carlo Alberto, Skrap Miran
Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy.
Neurology Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy.
Biomed Res Int. 2015;2015:497610. doi: 10.1155/2015/497610. Epub 2015 Oct 11.
Given the technical difficulties, a limited number of works have been published on insular gliomas surgery and risk factors for tumor recurrence (TR) are poorly documented.
The aim of the study was to determine TR in adult patients with initial diagnosis of insular Low-Grade Gliomas (LGGs) that subsequently underwent second surgery.
A consecutive series of 53 patients with insular LGGs was retrospectively reviewed; 23 patients had two operations for TR.
At the time of second surgery, almost half of the patients had experienced progression into high-grade gliomas (HGGs). Univariate analysis showed that TR is influenced by the following: extent of resection (EOR) (P < 0.002), ΔVT2T1 value (P < 0.001), histological diagnosis of oligodendroglioma (P = 0.017), and mutation of IDH1 (P = 0.022). The multivariate analysis showed that EOR at first surgery was the independent predictor for TR (P < 0.001).
In patients with insular LGG the EOR at first surgery represents the major predictive factor for TR. At time of TR, more than 50% of cases had progressed in HGG, raising the question of the oncological management after the first surgery.
鉴于技术上的困难，关于岛叶胶质瘤手术的已发表作品数量有限，且肿瘤复发（TR）的危险因素记录不足。
本研究的目的是确定最初诊断为岛叶低级别胶质瘤（LGG）且随后接受二次手术的成年患者的TR情况。
回顾性分析了连续的53例岛叶LGG患者；其中23例患者因TR接受了两次手术。
在二次手术时，几乎一半的患者已进展为高级别胶质瘤（HGG）。单因素分析显示，TR受以下因素影响：切除范围（EOR）（P < 0.002）、ΔVT2T1值（P < 0.001）、少突胶质细胞瘤的组织学诊断（P = 0.017）和IDH1突变（P = 0.022）。多因素分析显示，首次手术时的EOR是TR的独立预测因素（P < 0.001）。
在岛叶LGG患者中，首次手术时的EOR是TR的主要预测因素。在TR时，超过50%的病例已进展为HGG，这引发了首次手术后肿瘤管理的问题。
