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Journal of Neuro-Oncology

Erschienen in:

05.09.2023 | Case Study

Decision system for extent of resection in WHO grade 3 gliomas: a Chinese Glioma Genome Atlas database analysis

verfasst von: Ziming Hou, Jie Hu, Xing Liu, Zeya Yan, Kenan Zhang, Shengyu Fang, Tao Jiang, Yinyan Wang

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2023

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Abstract

Background

Extensive surgical resection has been found to be associated with longer survival in patients with gliomas, but the interactive prognostic value of molecular pathology of the surgical resection is unclear. This study evaluated the impact of molecular pathology and clinical characteristics on the surgical benefit in WHO grade 3 IDH-mutant gliomas.

Methods

Clinical and pathological information of 246 patients with WHO grade 3 IDH-mutant gliomas were collected from the Chinese Glioma Genome Atlas database (2006–2020). The role of the extent of resection on overall survival, stratified by molecular pathology and clinical characteristics, was investigated. We then assessed prognostic factors using a univariate log-rank test and multivariate Cox proportional hazards model in the subgroups.

Results

The extent of resection was an independent prognostic factor in the entire cohort, even when adjusted for molecular pathology. Gross total resection was found to be associated with longer survival in all patients and in the astrocytoma group but not in the oligodendroglioma group. Compared with subtotal resections, gross total resections resulted in a longer survival time for astrocytoma patients aged ≤ 45 years. However, there was no survival benefit from total resection in patients with astrocytoma aged > 45 years.

Conclusions

Extensive resection benefits only a proportion of patients with WHO grade 3 IDH-mutant gliomas. Younger patients with astrocytomas had survival benefits from extensive resection. In addition to clinical characteristics (especially age), molecular pathology impacted prognosis in patients with gliomas. Our findings provide guiding information to neurosurgeons while planning surgeries.

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Titel: Decision system for extent of resection in WHO grade 3 gliomas: a Chinese Glioma Genome Atlas database analysis
verfasst von: Ziming Hou
Jie Hu
Xing Liu
Zeya Yan
Kenan Zhang
Shengyu Fang
Tao Jiang
Yinyan Wang
Publikationsdatum: 05.09.2023
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 2/2023
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-023-04420-5

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Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

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