Lower grade gliomas (LGG) are typically infiltrative and diffuse growing lesions, commonly involving eloquent regions ( 1– 3). There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. Risk of an extended resection has to be balanced with the respective oncological benefit. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Complete tumor removal (CTR) was successfully in 62% of intended cases. Mild deficits remained in 29% and severe deficits in 10%. At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Eloquent region involved predominantly motor (45%) and language (40%). Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Patients without surgery or incomplete postoperative data were excluded. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. 10Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.9Department of Neurosurgery, KRH Klinikum Region Hannover, Hannover, Germany.8Department of Neurosurgery, University of Tübingen, Tübingen, Germany.7Department of Neurosurgery, Helios Hospital Erfurt, Erfurt, Germany.6Department of Neurosurgery, University of Frankfurt, Frankfurt am Main, Germany.5Department of Neurosurgery, Katharinenhospital Stuttgart, Stuttgart, Germany.4Department of Neurosurgery, University of Göttingen, Göttingen, Germany.3Department of Neurosurgery, University of Würzburg, Würzburg, Germany.2Department of Neurosurgery, Charité - University of Berlin, Berlin, Germany. 1Department of Neurosurgery, University of Ulm, Günzburg, Germany.Jan Coburger 1*, Julia Onken 2, Stefan Rueckriegel 3, Christian von der Brelie 4, Minou Nadji-Ohl 5, Marie-Therese Forster 6, Rüdiger Gerlach 7, Meike Unteroberdörster 2, Constantin Roder 8, Katja Kniese 9, Stefan Schommer 5, Dietrich Rothenbacher 10, Gabriele Nagel 10, Christian Rainer Wirtz 1, Ralf-Ingo Ernestus 3, Arya Nabavi 9, Marcos Tatagiba 8, Marcus Czabanka 6, Oliver Ganslandt 5, Veit Rohde 4, Mario Löhr 3, Peter Vajkoczy 2 and Andrej Pala 1
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |