Survey on current practice within the European Low-Grade Glioma Network: where do we stand and what is the next step?

Mandonnet, Emmanuel; Wager, Michel; Almairac, Fabien; Baron, Marie‐Hélène; Blonski, Marie; Freyschlag, Christian F.; Barone, Fabio; Fontaine, Denys; Pallud, Johan; Hegi, Monika E.; Viegas, Catarina; Zetterling, Maria; Spena, Giannantonio; Goodden, John; Rutten, Geert‐Jan; Taillandier, Luc; Foroglu, Nicolas; Darlix, Amélie; Škrap, Miran; Martino, Juan; Campe, Gord von; Madadaki, C.; Gayat, Étienne; Hamer, Philip C. De Witt; Robles, Santiago Gil; Sarubbo, Silvio; Santorius, Thomas; Bello, Lorenzo; Forster, Marie-Thérèse; Duffau, Hugues

doi:10.1093/nop/npw031

Cited by 14 publications

(14 citation statements)

References 34 publications

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“…Surgery plays a major role in the first-line treatment of gliomas [ 12 – 14 ]. Preserving neurological function is of upmost importance when it comes to surgical approaches and extent of tumor removal.…”

Section: Introductionmentioning

confidence: 99%

The ability to return to work: a patient-centered outcome parameter following glioma surgery

et al. 2020

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Background With refinements in diagnosis and therapy of gliomas, the importance of survival time as the sole outcome parameter has decreased, and patient-centered outcome parameters have gained interest. Pursuing a profession is an indispensable component of human happiness. The aim of this study was to analyze the professional outcomes besides their neuro-oncological and functional evaluation after surgery for gliomas in eloquent areas. Methods We assessed neuro-oncological and functional outcomes of patients with gliomas WHO grades II and III undergoing surgery between 2012 and 2018. All patients underwent routine follow-up and adjuvant treatment. Treatment and survival parameters were collected prospectively. Repercussions of the disease on the patients’ professional status, socio-economic situation, and neurocognitive function were evaluated retrospectively with questionnaires. Results We analyzed data of 58 patients with gliomas (WHO II: 9; III: 49). Median patient age was 35.8 years (range 21–63 years). Awake surgery techniques were applied in 32 patients (55.2%). Gross total and subtotal tumor resections were achieved in 33 (56.9%) and 17 (29.3%) patients, respectively, whereas in 8 patients (13.8%) resection had to remain partial. Most patients (n = 46; 79.3%) received adjuvant treatment. Median follow up was 43.8 months (range 11–82 months). After treatment 41 patients (70.7%) were able to resume a working life. Median time until returning to work was 8.0 months (range 0.2–22.0 months). To be younger than 40 at the time of the surgery was associated with a higher probability to return to work (p < .001). Multivariable regression analysis showed that patient age < 40 years as well as occupational group and self-reported fatigue were factors independently associated with the ability to return to work. Conclusion The ability to resume professional activities following brain tumor surgery is an important patient-oriented outcome parameter. We found that the majority of patients with gliomas were able to return to work following surgical and adjuvant treatment. Preservation of neurological function is of utmost relevance for individual patients´ quality of life.

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Section: Introductionmentioning

confidence: 99%

The ability to return to work: a patient-centered outcome parameter following glioma surgery

et al. 2020

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“…Answers to the survey were obtained from 21/28 centers (response rate 75%) distributed across 11 European countries. 26 In these centers, the median number of DLGG patients treated with chemotherapy in the “low-grade” period (before the anaplastic transformation) is 6 patients per year per center (range, 0-75) (15 respondents). A small proportion of these patients are included in clinical trials evaluating chemotherapy: 0 in 14/21 centers (66.7%), 1-5 in 4/21 centers (19%), 6-10 in 2/21 (9.5%), and >10 patients in 1/21 (4.8%) in 2014.…”

Section: Resultsmentioning

confidence: 99%

“…The methodology of the survey has been previously described. 26 In brief, an online survey investigating the management of DLGG patients (that is, patients with diffuse grade II glioma according to the WHO 2007 classification 1 ) was designed by a panel of experts from the ELGGN using Google forms and sent to all participating centers (n = 28) in May 2015. It was specified that only one form had to be completed for each center and recommended that it should be filled out by all physicians involved during a multidisciplinary meeting.…”

Section: Methodsmentioning

confidence: 99%

“…An online survey evaluating the current practices in the management of DLGG patients was sent to participating ELGGN centers in 2015, after the presentation of the results of the RTOG 9802 trial at the 2014 American Society of Clinical Oncology (ASCO) meeting. The general results of this survey have been previously published 26 along with detailed results regarding its cognitive, 27 surgical, 28 and imaging 29 aspects. In this article, we describe the results of the survey pertaining to the use of chemotherapy in DLGG.…”

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confidence: 99%

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Chemotherapy and diffuse low-grade gliomas: a survey within the European Low-Grade Glioma Network

Darlix

Mandonnet

Freyschlag

et al. 2018

Neuro-Oncology Practice

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Background Diffuse low-grade gliomas (DLGGs) are rare and incurable tumors. Whereas maximal safe, functional-based surgical resection is the first-line treatment, the timing and choice of further treatments (chemotherapy, radiation therapy, or combined treatments) remain controversial. Methods An online survey on the management of DLGG patients was sent to 28 expert centers from the European Low-Grade Glioma Network (ELGGN) in May 2015. It contained 40 specific questions addressing the modalities of use of chemotherapy in these patients. Results The survey demonstrated a significant heterogeneity in practice regarding the initial management of DLGG patients and the use of chemotherapy. Interestingly, radiation therapy combined with the procarbazine, CCNU (lomustine), and vincristine regimen has not imposed itself as the gold-standard treatment after surgery, despite the results of the Radiation Therapy Oncology Group 9802 study. Temozolomide is largely used as first-line treatment after surgical resection for high-risk DLGG patients, or at progression. Conclusions The heterogeneity in the management of patients with DLGG demonstrates that many questions regarding the postoperative strategy and the use of chemotherapy remain unanswered. Our survey reveals a high recruitment potential within the ELGGN for retrospective or prospective studies to generate new data regarding these issues.

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“…More than 30 years later, the neurosurgical field has expanded to the point that there is an increasing need of testing tools standardized for clinical practice, as well as an increasingly fine-grained analysis of intraoperative responses in the light of current cognitive models. Examples of this increased interest are the numerous studies regarding the neural substrates of many cognitive functions (e.g., Duffau, 2015; Giussani, Roux, Lubrano, Gaini, & Bello, 2007; Mandonnet, 2017; Zanin et al, 2017), descriptions of common practices among expert centres (Mandonnet, Wager, et al, 2017; Rofes, Mandonnet, et al, 2017), discussions of advantages and disadvantages of intraoperative tasks (e.g., Rofes & Miceli, 2014; Rofes, Spena, et al, 2015), the standardization of batteries of tasks to assess patients at different surgical stages (e.g., De Witte et al, 2015; Połczyńska, 2009), ethical considerations (Chiong, Leonard, & Chang, 2017), as well as the advent of neuro-anatomically specified models of language processing (e.g., Bohland & Guenther, 2006; Chang, Raygor, & Berger, 2015; Duffau, 2015; Duffau, Moritz-Gasser, & Mandonnet, 2014; Fernández-Coello et al, 2013; Hickok & Poeppel, 2004; Indefrey & Levelt, 2000; Mandonnet, 2017; Tourville & Guenther, 2011).…”

Section: Introductionmentioning

confidence: 99%

Language processing from the perspective of electrical stimulation mapping

Rofes

Mandonnet

Aguiar

et al. 2018

Cognitive Neuropsychology

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Electrical Stimulation (ES) is a neurostimulation technique that is used to localize language functions in the brain of people with intractable epilepsy and/or brain tumors. We reviewed 25 ES articles published between 1984 and 2018 and interpreted them from a cognitive neuropsychological perspective. Our aim was to highlight ES as a tool to further our understanding of cognitive models of language. We focused on associations and dissociations between cognitive functions within the framework of two non-neuroanatomically specified models of language. Also, we discussed parallels between the ES and the stroke literatures and showed how ES data can help us to generate hypotheses regarding how language is processed. A good understanding of cognitive models of language is essential to motivate task selection and to tailor surgical procedures, for example, by avoiding testing the same cognitive functions and understanding which functions may be more or less relevant to be tested during surgery.

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Survey on current practice within the European Low-Grade Glioma Network: where do we stand and what is the next step?

Cited by 14 publications

References 34 publications

The ability to return to work: a patient-centered outcome parameter following glioma surgery

The ability to return to work: a patient-centered outcome parameter following glioma surgery

Chemotherapy and diffuse low-grade gliomas: a survey within the European Low-Grade Glioma Network

Language processing from the perspective of electrical stimulation mapping

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