title: Management of patients with low-grade gliomas - a survey among German neurosurgical departments.
abstract: OBJECTIVE
  The diagnosis and treatment of low-grade gliomas (LGG) are multimodal. Today, there is no defined standard in diagnosis and treatment. Controversies are, in general, about a "wait-and-see" strategy, diagnostic workup, surgical intervention, postoperative imaging, adjuvant treatment, and follow-up. The aim of this study is to gain an overview about management strategies of high-volume German neurosurgical departments treating these patients.
  
  
  METHODS
  A questionnaire including diagnostic, preoperative, perioperative, and postoperative parameters and 5 cases with magnetic resonance imaging data with questions to various treatment options in these patients was sent to all 34 German neurosurgical departments at university hospitals.
  
  
  RESULTS
  In total, 24 questionnaires were returned and analysed. Centres were divided into those who generally practice a "wait-and-see" strategy vs. those who do not or only in highly selected cases. Statistical analyses were performed with Fisher test and Chi (2)-test. Interestingly, 50% of all centres routinely follow a "wait-and-see" strategy.
  
  
  CONCLUSIONS
  Although the management of patients with LGG is complex and a simple questionnaire will not be able to define a standard in diagnosis and treatment, this study offers an overview on strategies at high-volume academic centres dealing with these patients. There is consensus to resect superficially located lobar and circumscribed low-grade lesions. However, the differences between centres become apparent with increasing complexity of the lesions.
authors.affiliation: University Medical Center Mannheim, Department of Neurosurgery, Mannheim, Germany. marcel.seiz-rosenhagen@uki.at
authors.forename: M
authors.initials: M
authors.lastname: Seiz
authors.forename: C F
authors.initials: CF
authors.lastname: Freyschlag
authors.forename: S
authors.initials: S
authors.lastname: Schenkel
authors.forename: C
authors.initials: C
authors.lastname: Weiss
authors.forename: C
authors.initials: C
authors.lastname: Thomé
authors.forename: K
authors.initials: K
authors.lastname: Schmieder
authors.forename: W
authors.initials: W
authors.lastname: Stummer
authors.forename: J
authors.initials: J
authors.lastname: Tuettenberg
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001932:Brain Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D004247:DNA / Q000235:genetics; D005260:Female; D005858:Germany; D005910:Glioma / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D006040:Goals; D019538:Health Care Surveys; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009364:Neoplasm Recurrence, Local; D038361:Neuronavigation; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D049268:Positron-Emission Tomography; D011184:Postoperative Period; D025321:Surgery, Computer-Assisted; D011795:Surveys and Questionnaires; D057832:Watchful Waiting
chemical_list: D004247:DNA