Inter- and intrapatients comparison of WHO grade II glioma kinetics before and after surgical resection

Neurosurg Rev. 2010 Jan;33(1):91-6. doi: 10.1007/s10143-009-0229-x. Epub 2009 Oct 22.

Abstract

Grade II gliomas grow slowly and linearly (at rates about 4 mm/year) before undergoing anaplastic transformation. In order to analyze how surgery may affect radiological grade II glioma kinetics, we restrospectively reviewed our national database searching for patients operated on for a supratentorial grade II glioma between 1997 and 2007. We selected patients with at least two postoperative MRI with a minimal delay of 6 months. For each patient, postoperative residues were segmented on successive MRIs. Velocities of diameter expansion were estimated by linear regression of mean diameter evolution for each patient. Fifty-four patients fulfilled inclusion criteria. Median postoperative follow-up was 1.6 years with, on average, 3.4 MRI examinations per patient. Postoperative growth rates of mean diameter were normally distributed, around a mean value of 4.3 mm/year (SD = 3.2 mm/year). Statistical analysis showed no difference between this distribution and the distribution of preoperative growth rates in a previous series of 143 grade II gliomas. For a subset of 23 patients, delay between first MRI and surgery made it possible to estimate also preoperative growth rates. Intrapatient comparison revealed that growth rates were grossly unchanged for 80% of cases. In summary, inter- and intrapatient comparison of pre- and postoperative growth rates proves that surgery does not change grade II glioma dynamics, thus, acting as a cytoreduction.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Astrocytoma / pathology
  • Astrocytoma / surgery
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / surgery*
  • Brain Neoplasms / therapy
  • Child
  • Dacarbazine / analogs & derivatives
  • Dacarbazine / therapeutic use
  • Databases, Factual
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glioma / pathology*
  • Glioma / surgery*
  • Glioma / therapy
  • Humans
  • Kinetics
  • Linear Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neurosurgical Procedures*
  • Oligodendroglioma / pathology
  • Oligodendroglioma / surgery
  • Retrospective Studies
  • Temozolomide
  • Young Adult

Substances

  • Antineoplastic Agents, Alkylating
  • Dacarbazine
  • Temozolomide