Gliomas: survival differences between metropolitan and non-metropolitan counties

Best, Benjamin; Nguyen, Ha Son; Doan, Ninh; Gelsomino, Michael; Shabani, Saman; Jazi, Ghazaleh Ahmadi; Sadati, Mohsen; Sheikh, Sarvenaz; Adl, Farzad Hami; Taqi, Muhammad; Mortazavi, Martin M.

doi:10.23736/s0390-5616.18.04598-8

Cited by 7 publications

(5 citation statements)

References 25 publications

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“…Subtotal resection (STR) was defined as STR was defined as residual tumor of any degree, and patients were required to undergo enhanced MRI at 3 months and each subsequent year to assess tumor control. Patients were considered to have progressed if they required salvage treatment (surgery or radiosurgery) for clinical symptoms or tumor regrowth (>5 mm increase in the residual tumor size in the latest follow-up MRI) ( 9 , 13 ).…”

Section: Methodsmentioning

confidence: 99%

A Nomogram to Predict Recurrence-Free Survival Following Surgery for Vestibular Schwannoma

Zhang

Shi

et al. 2022

Front. Oncol.

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BackgroundVestibular schwannoma (VS) is the most common benign tumor of the posterior fossa. The recurrence of VS has always received widespread attention. This study aimed to develop a nomogram to predict Recurrence-free survival (RFS) following resection of VS.MethodsA total of 425 patients with VS who underwent resection at the Department of Neurosurgery in Chinese PLA General Hospital between January 2014 and December 2020 were enrolled in this retrospective study. The medical records and follow-up data were collected. Cox regression analysis was used to screen prognostic factors and construct the nomogram. The predictive accuracy and clinical benefits of the nomogram were validated using the area under the curve (AUC), calibration curves, and decision curve analysis (DCA).ResultsThe Cox regression analysis revealed that age (HR = 0.96; 95% CI 0.94 - 0.99; p < 0.01), EOR (HR = 4.65; 95% CI 2.22 - 9.74; p < 0.001), and Ki-67 (HR = 1.16; 95% CI 1.09 - 1.23; p < 0.001) were all significantly correlated with recurrence, and they were finally included in the nomogram model. The concordance index of the nomogram was 0.86. The areas under the curve (AUCs) of the nomogram model of 3-, 4- and 5-year were 0.912, 0.865, and 0.809, respectively. A well-fitted calibration curve was also generated for the nomogram model. The DCA curves also indicated that the nomogram model had satisfactory clinical utility compared to the single indicators.ConclusionsWe developed a nomogram that has high accuracy in predicting RFS in patients after resection of VS. All of the included prognostic factors are easy to obtain. The nomogram can improve the postoperative management of patients and assist clinicians in individualized clinical treatment. Furthermore, we generated a web-based calculator to facilitate clinical application: https://abc123-123.shinyapps.io/VS-RFS/.

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Section: Methodsmentioning

confidence: 99%

A Nomogram to Predict Recurrence-Free Survival Following Surgery for Vestibular Schwannoma

Zhang

Shi

et al. 2022

Front. Oncol.

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“…The optimal treatment of LGGs remains controversial and the most appropriate management of these tumors is not entirely clear, though a plethora of studies have made significant strides and efforts in order to precisely elucidate ideal therapeutic strategies. [1,2,5,25,29,[31][32][33][34]36,38,40,41,43,[46][47][48][49][50][51][52][53][54][55][56][57][58] For symptomatic LGGs in noneloquent parenchyma, there is general agreement that an aggressive resection proves ideal, [4,6,28,35,37,38,41,43,44] but for lesions that are asymptomatic, slow-growing, and/or located in eloquent cortex, the optimal management strategy remains disputed, with conservative [58] or surgical therapy [1,4,5,45,47,49] alternatively appropriate.…”

Section: Supratotal and Maximal Safe Resection Of Low Grade Gliomasmentioning

confidence: 99%

“…The importance of surgeon experience on survival and functional outcomes cannot be overemphasized. Improved outcomes for complex surgical problems are consistently correlated with surgeon experience and hospital volume in both neurological [45,72,73] as well as general [75][76][77][78][79] surgery, especially for more complex and challenging pathologies. [74,82] For instance, greater surgeon experience correlates with reduced mortality in laparoscopic major hepatectomies, [83] reduced postoperative complications and mortality following laparoscopic colorectal operative intervention, [84] enhanced recovery of urinary continence following robotic-assisted radical prostatectomy, [85] higher endocrinological cure rates for transsphenoidal resection of pituitary adenoma, [74] reduced postoperative corneal edema following cataract surgery, [86] reduced postoperative mortality following pancreaticoduodenectomy, [82] reduced postoperative complications following laparoscopic cholecystectomy, [87] and fewer complications following shoulder arthroplasty and hemiarthroplasty.…”

Section: Surgeon Experience and Patient Outcomesmentioning

confidence: 99%

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The ethical dilemma in the surgical management of low grade gliomas according to the variable availability of resources and surgeon experience

Lahiff

Ghali

2020

Asian J Neurosurg

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Low grade gliomas (LGGs) affect young individuals in the prime of life. Management may alternatively include biopsy and observation or surgical resection. Recent evidence strongly favors maximal and supramaximal resection of LGGs in optimizing survival metrics. Awake craniotomy with cortical mapping and electrical stimulation along with other preoperative and intraoperative surgical adjuncts, including intraoperative magnetic resonance and diffusion tensor imaging, facilitates maximization of resection and eschews precipitating neurological deficits. Intraoperative imaging permits additional resection of identified residual to be completed within the same surgical session, improving extent of resection and consequently progression free and overall survival. These resources are available in only a few centers throughout the United States, raising an ethical dilemma as to where patients harboring LGGs should most appropriately be treated.

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“…Overall, metropolitan status appears to influence short-term mortality and long-term observed survival for gliomas. [2] Moreover, the dilemma also exists in developing countries. However, lack of resources in underdeveloped and developing countries should not prevent suboptimal surgical planning in small and nonreferral centers, considering recent improvements in adjuvant therapy.…”

mentioning

confidence: 99%

Ethical dilemma in glioma surgery; How to opt for the holy grail?

Javadi

Khan

2020

Asian J Neurosurg

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Gliomas: survival differences between metropolitan and non-metropolitan counties

Cited by 7 publications

References 25 publications

A Nomogram to Predict Recurrence-Free Survival Following Surgery for Vestibular Schwannoma

A Nomogram to Predict Recurrence-Free Survival Following Surgery for Vestibular Schwannoma

The ethical dilemma in the surgical management of low grade gliomas according to the variable availability of resources and surgeon experience

Ethical dilemma in glioma surgery; How to opt for the holy grail?

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