title: Spontaneous and therapeutic prognostic factors in adult hemispheric World Health Organization Grade II gliomas: a series of 1097 cases: clinical article.
abstract: OBJECTIVE
  The spontaneous prognostic factors and optimal therapeutic strategy for WHO Grade II gliomas (GIIGs) have yet to be unanimously defined. Specifically, the role of resection is still debated, most notably because the actual amount of resection has seldom been assessed.
  
  
  METHODS
  Cases of GIIGs treated before December 2007 were extracted from a multicenter database retrospectively collected since January 1985 and prospectively collected since 1996. Inclusion criteria were a patient age ≥ 18 years at diagnosis, histological diagnosis of WHO GIIG, and MRI evaluation of tumor volume at diagnosis and after initial surgery. One thousand ninety-seven lesions were included in the analysis. The mean follow-up was 7.4 years since radiological diagnosis. Factors significant in a univariate analysis (with a p value ≤ 0.1) were included in the multivariate Cox proportional hazard regression model analysis.
  
  
  RESULTS
  At the time of radiological diagnosis, independent spontaneous factors of a poor prognosis were an age ≥ 55 years, an impaired functional status, a tumor location in a nonfrontal area, and, most of all, a larger tumor size. When the study starting point was set at the time of first treatment, independent favorable prognostic factors were limited to a smaller tumor size, an epileptic symptomatology, and a greater extent of resection.
  
  
  CONCLUSIONS
  This large series with its volumetric assessment refines the prognostic value of previously stressed clinical and radiological parameters and highlights the importance of tumor size and location. The results support additional arguments in favor of the predominant role of resection, in accordance with recently reported experiences.
authors.affiliation: Departments of Neurosurgery.
authors.forename: Laurent
authors.initials: L
authors.lastname: Capelle
authors.forename: Denys
authors.initials: D
authors.lastname: Fontaine
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mandonnet
authors.forename: Luc
authors.initials: L
authors.lastname: Taillandier
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Golmard
authors.forename: Luc
authors.initials: L
authors.lastname: Bauchet
authors.forename: Johan
authors.initials: J
authors.lastname: Pallud
authors.forename: Philippe
authors.initials: P
authors.lastname: Peruzzi
authors.forename: Marie Hélène
authors.initials: MH
authors.lastname: Baron
authors.forename: Michèle
authors.initials: M
authors.lastname: Kujas
authors.forename: Jacques
authors.initials: J
authors.lastname: Guyotat
authors.forename: Remi
authors.initials: R
authors.lastname: Guillevin
authors.forename: Marc
authors.initials: M
authors.lastname: Frenay
authors.forename: Sophie
authors.initials: S
authors.lastname: Taillibert
authors.forename: Philippe
authors.initials: P
authors.lastname: Colin
authors.forename: Valérie
authors.initials: V
authors.lastname: Rigau
authors.forename: Fanny
authors.initials: F
authors.lastname: Vandenbos
authors.forename: Catherine
authors.initials: C
authors.lastname: Pinelli
authors.forename: Hugues
authors.initials: H
authors.lastname: Duffau
mesh_terms: D000328:Adult; D000367:Age Factors; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D014944:World Health Organization; D055815:Young Adult