Supratentorial glioma WHO grade II. Retrospective analysis of 37 patients treated surgically between 1990-1999
Abstract
This retrospective study evaluates 37 patients with the diagnosis of glioma multiforme WHO grade H., operated upon in the Department of Neurosurgery, Masaryk Hospital in Usti nad Labem between 1990-1999. Based on our experience and literature review, we are trying to discuss the main controversial issues in treatment of this disease.
We consider the following as favourable prognostic factors regarding survival time: younger patient age, epilepsy as the sole presenting symptom (5-year survival in 81 %, 27 % dedifferentiation - in contrast to 52 % and 41 %, respectively, for other considered symptoms), absence of the gemistocytic subtype, and cortical localization of the tumour. Mean survival time in our study was significantly affected by the radicality of the resection - the extent of resection was evaluated by MRI or CT performed within 3 days after surgery.
In the case of radical resection, 5-and 8-year patient survival was achieved in 100 % and 67 %, respectively, in contrast to 65 % and 23 %, respectively, in patients with partial resection and to 33 % and 17 %, respectively, in patients with biopsy. We conclude that an exact volumetric quantification of the radicality of resection will be necessary for the subsequent prospective studies.