title: Effect of surgery on tumor progression and malignant degeneration in hemispheric diffuse low-grade astrocytomas.
abstract: The aim of this study is to determine the impact of surgery on tumor progression and malignant degeneration in hemispheric diffuse astrocytoma WHO grade II. Twenty-eight patients who were operated or underwent stereotactic biopsy for hemispheric diffuse astrocytoma WHO grade II at Marmara University between January 1987 and January 1996, were prospectively reviewed for the presence of recurrence and histopathological dedifferentiation at their fourth years after the initial treatment. Twenty-two patients underwent surgical resection. Of this group, 7 patients had a total, 11 had a subtotal and 4 patients had a partial resection. Six patients underwent stereotactic biopsy. All patients, except for the ones in whom a radiological total surgical removal could be achieved, received postoperative radiotherapy. In the total surgical-removal group only one patient had recurrence, while no upgrade was noted. All of the patients in the partial resection and stereotactic biopsy groups recurred at a higher grade. Our results indicate that both tumor progression and histopathological dedifferentiation were less commonly seen when a total or subtotal resection could be achieved. So, surgery, as radical as possible, should be the choice of treatment in low-grade hemispheric astrocytomas.
authors.affiliation: Marmara University Institute of Neurological Sciences, Istanbul, Turkey.
authors.forename: Türker
authors.initials: T
authors.lastname: Kiliç
authors.forename: Koray
authors.initials: K
authors.lastname: Ozduman
authors.forename: Ilhan
authors.initials: I
authors.lastname: Elmaci
authors.forename: Aydin
authors.initials: A
authors.lastname: Sav
authors.forename: M
authors.initials: M
authors.lastname: Necmettin Pamir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D001932:Brain Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures; D011446:Prospective Studies; D016896:Treatment Outcome