Ng Sam, Duffau Hugues
Institute of Functional Genomics, University of Montpellier, INSERM, CNRS, Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors," National Institute for Health and Medical Research (INSERM), U1191 Laboratory, Montpellier, France.
Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
Neurooncol Adv. 2025 May 20;7(1):vdaf102. doi: 10.1093/noajnl/vdaf102. eCollection 2025 Jan-Dec.
Maintaining quality of life is a priority of the oncological management in IDH-mutated low-grade gliomas (IDHm-LGGs). Yet, family outcomes have received limited attention. This study aims to provide an overview of long-term family outcomes in IDHm-LGG patients.
We retrospectively studied a consecutive cohort of IDHm-LGGs treated with awake functional-based resection (AwFR). The main outcomes were union/marriage, separation/divorce, and parenthood before/after surgery. We tested interactions with overall survival (OS), histomolecular data, therapeutics, occupations, and tumor locations.
A total of 538 patients were included (median age: 36 years [IQR: 30-44], 1p19q-codeletion: 237 [44.1%], median follow-up: 7.7 years [95% CI: 7.1-8.3]). Unions/marriages were observed in 374 (69.5%) patients preoperatively and were maintained in 329(61.2%) patients. Separations/divorces were observed in 41 (7.8%) patients. A total of 44 (8.2%) patients had new child/children, and 48 (9.1%) had new unions/marriages. Family status was stable in 399 (74.2%) patients. Prolonged single status was predicted by age (OR: 0.94, 95% CI: 0.91-0.98), female gender (OR: 0.48, 95% CI: 0.25-0.91), and previous child/children (OR: 0.23, 95% CI: 0.11-0.45). Total resection predicted new union/marriage and/or new child/children (OR: 2.59, 95% CI: 1.04-7.10). Occupational skill level (OR: 0.27, 95% CI: 0.05-0.95) predicted stable union/marriage, while previous parenthood predicted separation/divorce (OR: 2.73, 95% CI: 1.07-7.83). Lesion-symptom mapping revealed that right pars orbitalis/triangularis infiltrations (Liebermeister measures, < 0.05, 10 000 permutations) were associated with separation/divorce. Family status did not impact OS, as assessed by multivariable proportional hazard and propensity matching-based survival analyses.
This study offers a unique overview of the long-term family outcomes in IDHm-LGG patients. Critical interactions between familial, socio-professional, and oncological factors were highlighted. Despite the onset of the disease and the surgical approach, most patients had a stable family status.
维持生活质量是异柠檬酸脱氢酶（IDH）突变型低级别胶质瘤（IDHm-LGGs）肿瘤治疗管理的首要任务。然而，家庭结局受到的关注有限。本研究旨在概述IDHm-LGG患者的长期家庭结局。
我们回顾性研究了一组连续接受基于清醒功能的切除术（AwFR）治疗的IDHm-LGG患者队列。主要结局为手术前后的结婚/婚姻存续、分居/离婚以及生育情况。我们检验了其与总生存期（OS）、组织分子数据、治疗方法、职业和肿瘤位置之间的相互作用。
共纳入538例患者（中位年龄：36岁[四分位间距：30 - 44岁]，1p19q共缺失：237例[44.1%]，中位随访时间：7.7年[95%置信区间：7.1 - 8.3年]）。术前374例（69.5%）患者处于结婚/婚姻状态，术后329例（61.2%）维持该状态。41例（7.8%）患者分居/离婚。共有44例（8.2%）患者生育了新的子女，48例（9.1%）患者有了新的结婚/婚姻关系。399例（74.2%）患者的家庭状况稳定。年龄（比值比：0.94，95%置信区间：0.91 - 0.98）、女性性别（比值比：0.48，95%置信区间：0.25 - 0.91）和既往有子女（比值比：0.23，95%置信区间：0.11 - 0.45）可预测长期单身状态。肿瘤全切除可预测新的结婚/婚姻关系和/或生育新子女（比值比：2.59，95%置信区间：1.04 - 7.10）。职业技能水平（比值比：0.27，95%置信区间：0.05 - 0.95）可预测婚姻关系稳定，而既往生育情况可预测分居/离婚（比值比：2.73，95%置信区间：1.07 - 7.83）。病变 - 症状映射显示，右侧眶部/三角部浸润（利伯迈斯特测量法，P < 0.05，10000次排列）与分居/离婚相关。通过多变量比例风险分析和基于倾向匹配的生存分析评估，家庭状况不影响总生存期。
本研究对IDHm-LGG患者的长期家庭结局进行了独特的概述。强调了家庭、社会职业和肿瘤学因素之间的关键相互作用。尽管患病且接受了手术治疗，但大多数患者的家庭状况稳定。
