Nan Zhang1, Zhengda Yu1, N U Farrukh Hameed1, Geng Xu1, Yanyan Song2, Bin Wu1, Jie Zhang1, Tianming Qiu1, Dongxiao Zhuang1, Junfeng Lu3, Jinsong Wu1. 1. Glioma Surgery Division, Neurological Surgery Department of Huashan Hospital, Fudan University, Shanghai, China. 2. Department of Biostatistics, Institute of Medical Sciences, Shanghai Jiaotong University School of Medicine, Shanghai, China. 3. Glioma Surgery Division, Neurological Surgery Department of Huashan Hospital, Fudan University, Shanghai, China. Electronic address: hlujf@126.com.
Abstract
OBJECTIVE: To evaluate long-term functional and survival outcomes of patients with glioma after intraoperative neurophysiologic monitoring (IONM) application. METHODS: A total of 856 patients with glioma, who underwent tumor resection between October 2010 and March 2016, were included in this retrospective cohort study. All patients were stratified into IONM (439 patients) and non-IONM groups (417 patients). The primary outcome measured was overall survival (OS), and the secondary outcome measured was rate of late neurologic deficits. Analyses were performed using univariate tests and multivariate logistic regression and Cox proportional hazard model. RESULTS: The 2 cohorts were well balanced with respect to baseline characteristics. Univariate survival analysis showed longer OS in the IONM group than that in the non-IONM group (P = 0.036), especially in patients with high-grade astrocytic tumor (P = 0.034). The IONM group showed a lower rate of neurologic deficits than did the non-IONM group. Multivariate analysis showed that IONM was a favorable factor of OS (odds ratio, 0.776; P = 0.046) and late neurologic function (odds ratio, 0.583; P = 0.039). Dominant hemispheric and eloquent location of glioma had no association with OS. CONCLUSIONS: Application of IONM is beneficial to long-term functional and oncologic outcomes of patients with glioma.
OBJECTIVE: To evaluate long-term functional and survival outcomes of patients with glioma after intraoperative neurophysiologic monitoring (IONM) application. METHODS: A total of 856 patients with glioma, who underwent tumor resection between October 2010 and March 2016, were included in this retrospective cohort study. All patients were stratified into IONM (439 patients) and non-IONM groups (417 patients). The primary outcome measured was overall survival (OS), and the secondary outcome measured was rate of late neurologic deficits. Analyses were performed using univariate tests and multivariate logistic regression and Cox proportional hazard model. RESULTS: The 2 cohorts were well balanced with respect to baseline characteristics. Univariate survival analysis showed longer OS in the IONM group than that in the non-IONM group (P = 0.036), especially in patients with high-grade astrocytic tumor (P = 0.034). The IONM group showed a lower rate of neurologic deficits than did the non-IONM group. Multivariate analysis showed that IONM was a favorable factor of OS (odds ratio, 0.776; P = 0.046) and late neurologic function (odds ratio, 0.583; P = 0.039). Dominant hemispheric and eloquent location of glioma had no association with OS. CONCLUSIONS: Application of IONM is beneficial to long-term functional and oncologic outcomes of patients with glioma.
Authors: Michael C Jin; Allen L Ho; Austin Y Feng; Zachary A Medress; Arjun V Pendharkar; Paymon Rezaii; John K Ratliff; Atman M Desai Journal: Neurospine Date: 2022-03-31