Universität zu Köln

Delev, Daniel ORCID: 0000-0001-9444-0178, Heiland, Dieter Henrik, Franco, Pamela, Reinacher, Peter ORCID: 0000-0003-1691-546X, Mader, Irina, Staszewski, Ori ORCID: 0000-0002-0579-6701, Lassmann, Silke, Grau, Stefan and Schnell, Oliver (2019). Surgical management of lower-grade glioma in the spotlight of the 2016 WHO classification system. J. Neuro-Oncol., 141 (1). S. 223 - 234. NEW YORK: SPRINGER. ISSN 1573-7373

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Abstract

Purpose According to the 2016 WHO classification lower-grade gliomas consist of three groups: IDH-mutated and 1p/19q co-deleted, IDH-mutated and IDH-wildtype tumors. The aim of this study was to evaluate the impact of surgical therapy for lower-grade gliomas with a particular focus on the molecular subgroups. Methods This is a bi-centric retrospective analysis including 299 patients, who underwent treatment for lower-grade glioma between 1990 and 2016. All tumors were re-classified according to the 2016 WHO classification. Data concerning baseline and tumor characteristics, overall survival, different treatment modalities and functional outcome were analyzed. Results A total of 112 (37.5%) patients with IDH-mutation and 1p/19q co-deletetion, 86 (28.8%) patients with IDH-mutation and 101 (33.8%) patients with IDH-wildtype tumors were identified. The median overall survival (mOS) differed significantly between the groups (p < 0.001). Surgical resection was performed in 226 patients and showed significantly improved mOS compared to the biopsy group (p = 0.001). Gross total resection (GTR) was associated with better survival (p = 0.007) in the whole cohort as well as in the IDH-mutated and IDH-wildtype groups compared to partial resection or biopsy. IDH-wildtype patients presented a significant survival benefit after combined radio-chemotherapy compared to radio-or chemotherapy alone (p = 0.02). Good clinical status (NANO) was associated with longer OS (p = 0.001). Conclusion The impact of surgical treatment on the outcome of lower-grade gliomas depends to a great extent on the molecular subtype of the tumors. Patients with more aggressive tumors (IDH-wildtype) seem to profit from more intensive treatment like GTR, multiple resections and combined radio-/chemotherapy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Delev, Daniel UNSPECIFIED orcid.org/0000-0001-9444-0178 UNSPECIFIED Heiland, Dieter Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Franco, Pamela UNSPECIFIED UNSPECIFIED UNSPECIFIED Reinacher, Peter UNSPECIFIED orcid.org/0000-0003-1691-546X UNSPECIFIED Mader, Irina UNSPECIFIED UNSPECIFIED UNSPECIFIED Staszewski, Ori UNSPECIFIED orcid.org/0000-0002-0579-6701 UNSPECIFIED Lassmann, Silke UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnell, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-139984
DOI:	10.1007/s11060-018-03030-w
Journal or Publication Title:	J. Neuro-Oncol.
Volume:	141
Number:	1
Page Range:	S. 223 - 234
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1573-7373
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RESPONSE ASSESSMENT; VOLUMETRIC-ANALYSIS; SEIZURE FREEDOM; EANO GUIDELINE; IDH MUTATION; RESECTION; EXTENT; NEUROONCOLOGY; SURVIVAL; DIAGNOSIS Multiple languages Oncology; Clinical Neurology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13998