Tamara Ius1, Daniela Cesselli2, Miriam Isola2, Giada Pauletto3, Barbara Tomasino4, Stanislao D'Auria1, Daniele Bagatto5, Enrico Pegolo2, Antonio Paolo Beltrami2, Carla di Loreto2,6, Miran Skrap1. 1. Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy. 2. Department of Medicine, University of Udine, Udine, Italy. 3. Neurology Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy. 4. IRCCS E. Medea, Polo Regionale del FVG, San Vito al Tagliamento, Pordenone, Italy. 5. Department of Neuroradiology University of Udine, Udine, Italy. 6. Institute of Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy.
Abstract
BACKGROUND: Incidentally discovered diffuse low-grade gliomas (iLGG) are poorly documented in the literature. They are diagnosed by chance during radiological examinations. OBJECTIVE: To review a cohort of patients with iLGG surgically treated in our institution, analyzing clinical, molecular, and surgical aspects. METHODS: Clinical, radiological, and treatment data of iLGG were retrieved and compared with those of symptomatic diffuse LGGs (sLGG). Histological and molecular review was carried out as well. The extent of resection was evaluated on preoperative and postoperative T2-weighted magnetic resonance imaging. RESULTS: Thirty-four iLGG cases were identified within a monoinstitutional cohort of 332 patients operated for low-grade gliomas from 2000 to 2017. Clinically, patients with iLGG had higher preoperative karnofsky performance scale (KPS) (P = .003), smaller tumor volume (P = .0001), lower frequency of eloquent areas involvement (P = .0001), and higher rate of complete resection (P = .0001) compared to those with sLGG. No differences in the molecular profile and O6-methylguanine-DNA-methyltransferase promoter methylation were detected between iLGG and sLGG. Importantly, patients with iLGG had longer overall survival than those with sLGG (P = .0001), even when a complete surgical resection was achieved (P = .001). CONCLUSION: Although the therapeutic strategy of iLGG is still a matter of debate, our data support the safety and the effectiveness of early surgical resection. The favorable prognosis of iLGG may be due to the higher practicability of extensive resection, noneloquent tumor location, and smaller tumor volume.
BACKGROUND: Incidentally discovered diffuse low-grade gliomas (iLGG) are poorly documented in the literature. They are diagnosed by chance during radiological examinations. OBJECTIVE: To review a cohort of patients with iLGG surgically treated in our institution, analyzing clinical, molecular, and surgical aspects. METHODS: Clinical, radiological, and treatment data of iLGG were retrieved and compared with those of symptomatic diffuse LGGs (sLGG). Histological and molecular review was carried out as well. The extent of resection was evaluated on preoperative and postoperative T2-weighted magnetic resonance imaging. RESULTS: Thirty-four iLGG cases were identified within a monoinstitutional cohort of 332 patients operated for low-grade gliomas from 2000 to 2017. Clinically, patients with iLGG had higher preoperative karnofsky performance scale (KPS) (P = .003), smaller tumor volume (P = .0001), lower frequency of eloquent areas involvement (P = .0001), and higher rate of complete resection (P = .0001) compared to those with sLGG. No differences in the molecular profile and O6-methylguanine-DNA-methyltransferase promoter methylation were detected between iLGG and sLGG. Importantly, patients with iLGG had longer overall survival than those with sLGG (P = .0001), even when a complete surgical resection was achieved (P = .001). CONCLUSION: Although the therapeutic strategy of iLGG is still a matter of debate, our data support the safety and the effectiveness of early surgical resection. The favorable prognosis of iLGG may be due to the higher practicability of extensive resection, noneloquent tumor location, and smaller tumor volume.
Authors: Tamara Ius; Sam Ng; Jacob S Young; Barbara Tomasino; Maurizio Polano; David Ben-Israel; John J P Kelly; Miran Skrap; Hugues Duffau; Mitchel S Berger Journal: Neuro Oncol Date: 2022-04-01 Impact factor: 13.029
Authors: Tamara Ius; Edoardo Mazzucchi; Barbara Tomasino; Giada Pauletto; Giovanni Sabatino; Giuseppe Maria Della Pepa; Giuseppe La Rocca; Claudio Battistella; Alessandro Olivi; Miran Skrap Journal: Sci Rep Date: 2021-05-11 Impact factor: 4.379
Authors: Anjali Pradhan; Khashayar Mozaffari; Farinaz Ghodrati; Richard G Everson; Isaac Yang Journal: J Neurooncol Date: 2022-06-15 Impact factor: 4.506