Extent of Surgical Resection in Lower-Grade Gliomas: Differential Impact Based on Molecular Subtype
Diffuse lower-grade gliomas are classified into prognostically meaningful molecular subtypes. We aimed to determine the impact of surgical resection on overall survival in lower-grade glioma molecular subtypes. For 172 patients with lower-grade gliomas (World Health Organization grade II or III), pr...
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| Published in: | American journal of neuroradiology : AJNR Vol. 40; no. 7; pp. 1149 - 1155 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
American Society of Neuroradiology
01-07-2019
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Diffuse lower-grade gliomas are classified into prognostically meaningful molecular subtypes. We aimed to determine the impact of surgical resection on overall survival in lower-grade glioma molecular subtypes.
For 172 patients with lower-grade gliomas (World Health Organization grade II or III), pre- and postsurgical glioma volumes were determined using a semiautomated segmentation software based on FLAIR or T2-weighted MR imaging sequences. The association of pre- and postsurgical glioma volume and the percentage of glioma resection with overall survival was determined for the entire cohort and separately for lower-grade glioma molecular subtypes based on
(
) and 1p/19q status, after adjustment for age, sex, World Health Organization grade, chemotherapy administration, and radiation therapy administration.
For the entire cohort, postsurgical glioma volume (hazard ratio, 1.80; 95% CI, 1.18-2.75;
= .006) and the percentage of resection (hazard ratio, 3.22; 95% CI, 1.79-5.82;
< .001) were associated with overall survival. For
-mutant 1p/19q-codeleted oligodendrogliomas, the percentage of resection (hazard ratio, 6.69; 95% CI, 1.57-28.46;
= .01) was associated with overall survival. For
-mutant 1p/19q-noncodeleted astrocytomas, presurgical glioma volume (hazard ratio, 3.20; 95% CI, 1.22-8.39;
= .018), postsurgical glioma volume (hazard ratio, 2.33; 95% CI, 1.32-4.12;
= .004), and percentage of resection (hazard ratio, 4.34; 95% CI, 1.74-10.81;
= .002) were associated with overall survival. For
-wild-type lower-grade gliomas, pre-/postsurgical glioma volume and percentage of resection were not associated with overall survival.
The extent of surgical resection has a differential survival impact in patients with lower-grade gliomas based on their molecular subtype.
-mutant lower-grade gliomas benefit from a greater extent of surgical resection, with the strongest impact observed for
-mutant 1p/19q-noncodeleted astrocytomas. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0195-6108 1936-959X |
| DOI: | 10.3174/ajnr.A6102 |