TY - JOUR
T1 - Low grade gliomas
T2 - Functional mapping resection strategies, extent of resection, and outcome
AU - Berger, Mitchel S.
AU - Rostomily, Robert C.
N1 - Funding Information:
This work was supported by the American Cancer Society Professor of Clinical Oncology Grant #071 (MSB), NIH-1 U01-CA62428-01 (MSB) and NIH-1 R21-CA70790-01 (MSB).
PY - 1997/8
Y1 - 1997/8
N2 - The impact of surgery on outcome of adult patients with low-grade gliomas is controversial. Without prospective randomized treatment trials, one is primarily dependent on retrospective studies to address this issue. This paper reviews the recent clinical series of low-grade gliomas in which the association between extent of resection (EOR) and outcome could be analyzed. Functional stimulation mapping methods will be described to point out their critical role in maximizing the extent of resection while minimizing the risk associated with radical resection of low-grade gliomas. Studies from the CT-era analyzed with multivariate statistical methods were emphasized. The analysis of these studies points out that, for astrocytomas, there is no clear consensus that a greater EOR improves survival, but in most series under review, greater EOR significantly extended the survival of patients with oligodendroglioma. Unfortunately, there is little data which specifically analyzes and stratifies the outcome for other end-points such as time to progression, malignant degeneration, mortality and morbidity, and duration of high quality survival by EOR.
AB - The impact of surgery on outcome of adult patients with low-grade gliomas is controversial. Without prospective randomized treatment trials, one is primarily dependent on retrospective studies to address this issue. This paper reviews the recent clinical series of low-grade gliomas in which the association between extent of resection (EOR) and outcome could be analyzed. Functional stimulation mapping methods will be described to point out their critical role in maximizing the extent of resection while minimizing the risk associated with radical resection of low-grade gliomas. Studies from the CT-era analyzed with multivariate statistical methods were emphasized. The analysis of these studies points out that, for astrocytomas, there is no clear consensus that a greater EOR improves survival, but in most series under review, greater EOR significantly extended the survival of patients with oligodendroglioma. Unfortunately, there is little data which specifically analyzes and stratifies the outcome for other end-points such as time to progression, malignant degeneration, mortality and morbidity, and duration of high quality survival by EOR.
KW - Brain mapping
KW - Extent of resection
KW - Low-grade gliomas
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U2 - 10.1023/A:1005715405413
DO - 10.1023/A:1005715405413
M3 - Article
C2 - 9210055
AN - SCOPUS:0030958712
SN - 0167-594X
VL - 34
SP - 85
EP - 101
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 1
ER -