Inter- and intrapatients comparison of WHO grade II glioma kinetics before and after surgical resection.
Grade II gliomas grow slowly and linearly (at rates about 4 mm/year) before undergoing anaplastic transformation. In order to analyze how surgery may affect radiological grade II glioma kinetics, we restrospectively reviewed our national database searching for patients operated on for a supratentorial grade II glioma between 1997 and 2007. We selected patients with at least two postoperative MRI with a minimal delay of 6 months. For each patient, postoperative residues were segmented on successive MRIs. Velocities of diameter expansion were estimated by linear regression of mean diameter evolution for each patient. Fifty-four patients fulfilled inclusion criteria. Median postoperative follow-up was 1.6 years with, on average, 3.4 MRI examinations per patient. Postoperative growth rates of mean diameter were normally distributed, around a mean value of 4.3 mm/year (SD = 3.2 mm/year). Statistical analysis showed no difference between this distribution and the distribution of preoperative growth rates in a previous series of 143 grade II gliomas. For a subset of 23 patients, delay between first MRI and surgery made it possible to estimate also preoperative growth rates. Intrapatient comparison revealed that growth rates were grossly unchanged for 80% of cases. In summary, inter- and intrapatient comparison of pre- and postoperative growth rates proves that surgery does not change grade II glioma dynamics, thus, acting as a cytoreduction.
Neurosurgical Department, Hôpital Lariboisière, Paris, France. mandonnet@mac.com
Emmanuel
E
Mandonnet
Johan
J
Pallud
Denys
D
Fontaine
Luc
L
Taillandier
Luc
L
Bauchet
Philippe
P
Peruzzi
Jacques
J
Guyotat
Valérie
V
Bernier
Marie-Hélène
MH
Baron
Hugues
H
Duffau
Laurent
L
Capelle
D000293:Adolescent; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001254:Astrocytoma / Q000473:pathology / Q000601:surgery; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D002648:Child; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007700:Kinetics; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures; D009837:Oligodendroglioma / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D000077204:Temozolomide; D055815:Young Adult
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide