The impact of tumour volume and surgery on the outcome of adults with supratentorial WHO grade II astrocytomas and oligoastrocytomas

Abstract

Pre- and postoperative tumour volumes, and the involvement of more than one lobe were strongly associated with worse outcome. Preoperative tumour volume was the strongest predictor of OS (p<0.01) and the only predictor of MT (p<0.05). The absolute and relative volumes of tumour removed by surgery were not significantly associated with outcome. CONCLUSIONS. Initial tumour volume, measured as the volume of T2-hyperintensity on MRI, and tumour extension are the strongest predictors of outcome in patients with supratentorial diffuse astrocytic WHO Grade II tumours. The potential benefit of aggressive tumour resection needs to be investigated in a prospective controlled trial.

Stereotactic interstitial brachytherapy for the treatment of oligodendroglial brain tumors

“…Surgery continues to be the preferred treatment for most patients with low-grade gliomas (LGG). While some studies demonstrated that the extent of resection of LGG including OG favorably affects outcome [20][21][22][23][24] others did not confirm this finding [25][26][27][28].…”

Objective Response to Radiation Therapy and Long-Term Survival of Patients with WHO Grade II Astrocytic Gliomas with Known LOH 1p/19q Status

“…A potential problem with our approach of measuring the tumor volume based on MRI [15] is that hyperintensity changes on T2-weighted and FLAIR images, especially in the long-term follow-up, can be side effects of radiation [5]. Even if postirradiation changes might interfere in the evaluation of tumor progression after RT in the long term, they should not influence the assessment of tumor response, which is characterized by a reduction of the T2-hyperintense, neoplastic regions relatively early after treatment.…”

“…From our database of WHO grade II glioma patients [14,15] we selected those subjected to RT. The survival data were updated in March 2005 for all patients.…”

“…None of the patients had received chemotherapy by that time [14]. Digitalized pre-RT and post-RT magnetic resonance images (MRIs) were interactively analyzed using a dedicated software (NIH Image for Macintosh by Wayne Rasband, modified for use with Windows, © 2000 Scion Corporation), as described [15]. Tumor volumes were measured based on the entire region of hyperintensity (compared to normal brain) in T2-weighted and FLAIR MRIs.…”

Low-grade astrocytoma: surgical outcomes in eloquent versus non-eloquent brain areas

“…removal, as patients with more extensive tumor resection had significantly longer OS 11,[14][15][16]19,20 . Our data showed a very similar KPS at diagnosis between these two groups.…”