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Diffuse low grade gliomas

Publication at First Faculty of Medicine |
2020

Abstract

Diffuse low grade gliomas (grade II) are heterogenous neuroepithelial tumours, which are known for their infiltrative growth and their distinct histological profile does not match the criteria of the dia-gnosis of high grade gliomas (grade III, IV). The incidence of diffuse low grade gliomas is significantly lower in comparison to other primary brain tumours.

Nevertheless these tumours deserve attention because of their frequent occurence in younger patients and the negative consequences of their bio-logical behaviour in combination with mostly long-term complications associated with oncological treatment. Dia-gnostics and the individualization of treatment are constantly improving thanks to the ongoing development in the fields of histopathology, cytogenetics and neuroimaging methods.

Currently the main treatment option is a radical surgical removal of the tumour with the effort to minimalize the risk of new neurological deficit. Despite the apparently sufficient extent of the resection, further means, such as radiotherapy and/or chemotherapy, are included in the treatment regimen.

The timing and modifications of this adjuvant treatment depend on the specific molecular features of the tumour in a combination with other prognostic factors. However, the curability of diffuse low grade gliomas cannot be achieved, mainly due to their infiltrative growth.

The main goal of the neurosurgical procedure and oncological treatment is to delay the time to progression and subsequent dediferenciation and thus to prolong the survival of the glioma patients with emphasis on preserving their quality of life. The article aims to summarize current knowledge about diffuse low grade gliomas.