Natural History and Growth Patterns of Incidentally Discovered Diffusely Infiltrating Low-Grade Gliomas: A Volumetric Study

Opoku-Darko, Michael; Eagles, Matthew E; Cadieux, Magalie; Isaacs, Albert M.; Kelly, John J.

doi:10.1016/j.wneu.2019.08.235

Cited by 14 publications

(8 citation statements)

References 19 publications

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“…In this study, through a dynamic comparison of the maximum tumor diameters, we found that iLGGs showed slow, continuous growth, with an annual average growth rate of 2.7 ± 1.0 mm that fluctuated between 1 and 5 mm, which was consistent with the studies of other scholars 2 , 12 , 13 . According to growth features, if the lesion size shows a growth rate of several centimeters per year, it is often believed that the lesion is highly malignant.…”

Section: Discussionsupporting

confidence: 90%

A survival analysis of surgically treated incidental low-grade glioma patients

Zeng

Mei

et al. 2021

Sci Rep

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To evaluate the surgical effect on survival in patients with incidental low-grade glioma (LGG) through comparison between asymptomatic and symptomatic patients. The medical records of surgically treated adult cerebral incidental LGG (iLGG) patients in our department between January 2008 and December 2015 were retrospectively reviewed. The survival of patients was calculated starting from the initial imaging diagnosis. Factors related to progression-free survival (PFS), overall survival (OS) and malignant progression-free survival (MPFS) were statistically analyzed. Seventy-five iLGG patients underwent surgery: 49 in the asymptomatic group, who underwent surgery in the asymptomatic period, and 26 in the symptomatic group, who underwent surgery after the tumor had grown and the patients had developed tumor-related symptoms. Significantly more tumors were initially located adjacent to the functional area in the symptomatic group than in the asymptomatic group (P < 0.05), but there was no significant difference in the total resection rate between the two groups. The incidence of postoperative complications (15.4%) and postoperative epilepsy (23.1%) was higher in the symptomatic group than in the asymptomatic group (4.1% and 10.2%, respectively). Multivariate analysis showed that surgical timing, namely, surgery performed before or after symptom occurrence, had no significant effect on PFS, OS or MPFS, while total resection significantly prolonged PFS, OS and MPFS, and the pathology of oligodendroglioma was positively correlated with PFS and OS (P < 0.05). Surgical timing for iLGGs should facilitate total resection. If total resection can be achieved, even after symptom occurrence, patients can achieve comparable survival benefits to those treated with surgery in the asymptomatic phase.

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Section: Discussionsupporting

confidence: 90%

A survival analysis of surgically treated incidental low-grade glioma patients

Zeng

Mei

et al. 2021

Sci Rep

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“…The velocity of tumour growth or VDE appeared in four studies, with thresholds at ≥4 mm/y, ≥8 mm/y, and ≥12 cm/y. Incidentally discovered LGGs were found to grow 2.93 mm/y, 62 while VDE ≥ 12 cm/y are infrequently encountered, setting two accepted thresholds at ≥4 mm and ≥8 mm/y, with the latter weighing worse prognostication. In addition, the presence of SVZ involvement appears to compound VDE and initial tumour volume appears to compound VDE.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the presence of SVZ involvement appears to compound VDE and initial tumour volume appears to compound VDE. 62 …”

Section: Discussionmentioning

confidence: 99%

Systematic review—Time to malignant transformation in low-grade gliomas: Predicting a catastrophic event with clinical, neuroimaging, and molecular markers

Satar

Hotton

Samandouras

2021

Neuro-Oncology Advances

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Background Despite an initially indolent course, all WHO grade II, LGGs inevitably transform to malignant, WHO grades III and IV, without current curative options. Malignant transformation (MT) remains unpredictable with limited prognostic markers to steer timing of interventions. The aim of this study was to review and assign predictive value to specific clinical, molecular and radiological markers impacting MT, thereby justifying timely therapeutic interventions. Methods Searches of MEDLINE, Embase and Cochrane databases were conducted from inception to April 28, 2021 and outputs were analysed in accordance with PRISMA protocol. Results From an initial 5,032 articles, 31 articles were included, totalling 5,193 patients. Forty-three prognostic factors were registered to significantly impact MT. These were categorised as 7 clinical; 14 neuroimaging; 8 biological/molecular; 3 volumetric; 5 topological; 3 histological; and 3 treatment-related. Following analysis, 10 factors were highlighted: the pre-operative prognosticators were 1. presentation with epileptic seizures; 2. VDE >8mm/year; 3. VDE >4mm/year; 4. rCBV >1.75; 5. PTV ≥5 cm (65ml); 6. PTV ≥100 ml; and 7. cortical involvement. The post-operative prognosticators were 1.IDH-wt; 2. TP53 mutation; and 3. temozolomide monotherapy. Conclusions The management of LGGs remains controversial, as conservative and invasive treatment may be associated with MT and impaired quality of life, respectively. Our review indicates that MT can be predicted by specific metrics in VDE, PTV and rCBV, alongside cortical involvement. Additionally, patients with IDH-wt tumours TP53 mutations, or receiving TMZ monotherapy are more likely to undergo MT. Our data may form the basis of a predictive scoring system.

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“…In the new classification of central nervous system tumours from 2016, the phenotypical and genotypical manifestation are in the foreground. The molecular markers like isocitrate dehydrogenase (IDH) mutant / wild type, codeletion of chromosome 1p and 19q, α thalassemia mental retardation Xlinked (ATRX) and tumour protein p53 (TP53) genes stratify patients in groups with the same prognostic and guides the cases to a specific therapeutic protocol [36,43]. According to those markers, nowadays, LGG grade II includes: oligodendroglioma IHD mutant and 1p / 19q codeleted, diffuse astrocytoma IDH mutant and diffuse astrocytoma IDH wild type.…”

mentioning

confidence: 99%

“…In a study from 2013, Pallud et al, evaluated 148 iLGG cases and observed that the mean time duration until the next phase was 14 ± 7,8 years [46]. Concerning the growth rate of iLGG which was obtained after at list two MRI investigation evaluation at 3 months interval was found to be ranging from 2,93 mm/year (Opoku -Darko et al, 2019) to approximately 4mm/year (Pallud et al, 2013) [43,46].…”

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confidence: 99%

The evolution of eloquent located low-grade gliomas surgical approaches, their natural history and molecular classification

Coșman¹,

Cucu²,

Iordache³

et al. 2021

roneuro

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Low-grade glioma is characterized by slow growth, infiltrative pattern through white matter tracts and progression to a malignant tumour type. The traditional classification is newly replaced by molecular stratification. This reorganisation gathers glioma with similar prognosis and treatment protocols. The preferential location of that tumour in eloquent areas constituted, over time, a real challenge regarding the best surgical approach. Because of the high risk of postoperative neurological deficits initially a more conservative management was adopted. Once with the development of preoperative and intraoperative functional assessment techniques, a higher degree of resection was possible in the limits of cortico-subcortical eloquence, being well known that this is a statistically significant factor for survival. We present in this paper the natural evolution of low-grade glioma, their new molecular classification, prognostic factors and the various approach proposed for eloquent ones.

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Natural History and Growth Patterns of Incidentally Discovered Diffusely Infiltrating Low-Grade Gliomas: A Volumetric Study

Cited by 14 publications

References 19 publications

A survival analysis of surgically treated incidental low-grade glioma patients

A survival analysis of surgically treated incidental low-grade glioma patients

Systematic review—Time to malignant transformation in low-grade gliomas: Predicting a catastrophic event with clinical, neuroimaging, and molecular markers

The evolution of eloquent located low-grade gliomas surgical approaches, their natural history and molecular classification

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