Postoperative follow-up for selected diffuse low-grade gliomas with WHO grade III/IV foci
| Autor: | Valérie Rigau, Amélie Darlix, M. Fabbro, Julien Fraisse, Catherine Gozé, Hugues Duffau |
|---|---|
| Přispěvatelé: | Institut du Cancer de Montpellier (ICM), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM) |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_treatment Malignant transformation MESH: Glioma 0302 clinical medicine MESH: Postoperative Period Postoperative Period Young adult 10. No inequality Brain Neoplasms Glioma Prognosis 3. Good health Survival Rate MESH: Young Adult MESH: Chemotherapy Adjuvant Chemotherapy Adjuvant 030220 oncology & carcinogenesis MESH: Brain Neoplasms [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] Female Adult medicine.medical_specialty MESH: Survival Rate [SDV.CAN]Life Sciences [q-bio]/Cancer MESH: Prognosis Time-to-Treatment 03 medical and health sciences Young Adult medicine Adjuvant therapy Humans MESH: Time-to-Treatment Survival rate Retrospective Studies Chemotherapy MESH: Humans business.industry MESH: Adult MESH: Retrospective Studies Retrospective cohort study medicine.disease MESH: Male Surgery Radiation therapy Neurology (clinical) business MESH: Female 030217 neurology & neurosurgery |
| Zdroj: | Neurology Neurology, American Academy of Neurology, 2020, 94 (8), pp.e830-e841. ⟨10.1212/WNL.0000000000008877⟩ |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/WNL.0000000000008877⟩ |
| Popis: | ObjectiveDiffuse low-grade gliomas (DLGG) are defined by continuous growth and an almost unavoidable malignant transformation. Foci of malignant glioma can be found within DLGG samples obtained from surgical resections. As the medical management of patients is classically based on the higher tumor grade, an immediate adjuvant treatment is usually proposed. To determine whether postponing the medical treatment in selected patients is feasible, we conducted a single-center retrospective study.MethodsThis was a single-center retrospective analysis of a consecutive series of DLGG managed with this conservative strategy. Inclusion criteria were at least 1 focus of malignant tumor (grade III–IV, WHO 2016), no previous chemotherapy or radiotherapy, no less than a subtotal resection of the fluid-attenuated inversion recovery tumor volume, no intention of treating with immediate adjuvant therapy, and minimum 2 years of follow-up. The time interval to the following oncologic medical treatment was analyzed, as well as the functional and survival results.ResultsForty-four patients met the inclusion criteria (median age 36, median time interval from diagnosis 7 months). Most tumors (88%) were IDH-mutant and 1p19q intact (59%); 9 presented with grade IV foci. With a median follow-up of 6.7 years, 75% of patients received a subsequent medical treatment, after a median time of 3.4 years since surgery. At the time of analysis, 9 patients (20.0%) had died (5- and 7-year survival rates: 95% and 67.0%). Most surviving patients were still active professionally, without seizures.ConclusionsPostponing the medical treatment in DLGG with foci of malignant tumor following total or subtotal resection should be considered in selected patients. |
| Databáze: | OpenAIRE |
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