title: Low-grade astrocytoma: surgical outcomes in eloquent versus non-eloquent brain areas.
abstract: A retrospective study of 81 patients with low-grade astrocytoma (LGA) comparing the efficacy of aggressive versus less aggressive surgery in eloquent and non-eloquent brain areas was conducted. Extent of surgical resection was analyzed to assess overall survival (OS) and progression- free survival (PFS). Degree of tumor resection was classified as gross total resection (GTR), subtotal resection (STR) or biopsy. GTR, STR and biopsy in patients with tumors in non-eloquent areas were performed in 31, 48 and 21% subjects, whereas in patients with tumors in eloquent areas resections were 22.5, 35 and 42.5%. Overall survival was 4.7 and 1.9 years in patients with tumors in non-eloquent brain areas submitted to GTR/STR and biopsy (p=0.013), whereas overall survival among patients with tumors in eloquent area was 4.5 and 2.1 years (p=0.33). Improved outcome for adult patients with LGA is predicted by more aggressive surgery in both eloquent and non-eloquent brain areas.
authors.affiliation: Department of Neurology, Universidade de São Paulo, Brazil. ambbr@uol.com.br
authors.forename: André de Macedo
authors.initials: Ade M
authors.lastname: Bianco
authors.forename: Flavio Key
authors.initials: FK
authors.lastname: Miura
authors.forename: Carlos
authors.initials: C
authors.lastname: Clara
authors.forename: Jose Reynaldo W
authors.initials: JR
authors.lastname: Almeida
authors.forename: Clemar Correa da
authors.initials: CC
authors.lastname: Silva
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.forename: Suely K Nagahashi
authors.initials: SK
authors.lastname: Marie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001706:Biopsy; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D019635:Neurosurgical Procedures / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult