Long-term surgical and seizure outcomes of frontal low-grade gliomas

Int J Surg. 2016 Sep:33 Pt A:60-4. doi: 10.1016/j.ijsu.2016.07.065. Epub 2016 Jul 28.

Abstract

Introduction: Low-grade gliomas are infrequent lesions requiring special emphasis because of their relatively long follow-up time, and therefore the need for patients' well-being. Surgery provides not only increased survival but also improved quality of life for these patients. The purpose of this study was to present surgical series of frontal low-grade gliomas that were operated in our clinic and to discuss their epileptic and functional outcomes.

Methods: A series of 40 patients with low-grade glioma (WHO Grade II) were retrospectively analysed for patient characteristics, tumour location, epileptic history, surgery type (awake craniotomy, general anaesthesia), extent of resection and complications.

Results: Tumour was localized to primary motor area in most of the cases (35%, n = 14), 25 patients were operated under general anaesthesia and 15 with awake craniotomy. New deficit rate in the early postoperative period was 32.5% (dysarthria in one patient and motor deficits in 12). Karnofsky scores were ≥90 in 92.5% of the patients at the late follow-up. 31 patients were Engel I (77.5%), 5 were Engel II (12.5%) and 4 were Engel IV (10%) postoperatively.

Conclusion: Frontal LGGs are eligible to resect vigorously without persistent functional deficits. Patients with immediate postoperative complications benefit from neuro-rehabilitation. However, pre-existing speech dysfunctions are hard to recover with surgery. Surgical resection ends with favourable epileptic outcomes whereas tumour location may influence the results.

Keywords: Epilepsy; Frontal; Glioma; Low-grade; Outcome.

MeSH terms

  • Adult
  • Brain Neoplasms / complications
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / surgery*
  • Craniotomy
  • Female
  • Frontal Lobe*
  • Glioma / complications
  • Glioma / diagnostic imaging
  • Glioma / surgery*
  • Humans
  • Karnofsky Performance Status
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Quality of Life
  • Retrospective Studies
  • Seizures / etiology
  • Seizures / pathology
  • Seizures / prevention & control*
  • Treatment Outcome
  • Young Adult