title: A new functional classification system (FGA/B) with prognostic value for glioma patients.
abstract: Despite advances in multimodal treatments, malignant gliomas remain characterized by a short survival time. Surgical treatment is accepted to be the first line of therapy, with recent studies revealing that maximal possible tumor reduction exerts significant impact on patient outcome. Consideration of tumor localization in relation to functionally eloquent brain areas has been gaining increasing importance. Despite existing assessment methods, the availability of a simple but reliable preoperative grading based on functional data would therefore prove to be indispensable for the prediction of postoperative outcome and hence for overall survival in glioma patients. We performed a clinical investigation comprising 322 patients with gliomas and developed a novel classification system of preoperative tumor status, which considers tumor operability based on two graduations (Friedlein Grading - FG): FGA with lesions at safe distance to eloquent regions which can be completely resected, and FGB referring to tumors which can only be partially resected or biopsied. Investigation of outcome revealed that FGA were characterized by a significantly longer overall survival time compared to FGB. We offer the opportunity to classify brain tumors in a dependable and reproducible manner. The FGA/B grading method provides high prognostic value with respect to overall survival time in relation to the extent of location-dependent tumor resection.
authors.affiliation: Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nürnberg (FAU).
authors.forename: Katharina
authors.initials: K
authors.lastname: Friedlein
authors.affiliation: Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nürnberg (FAU).
authors.forename: Yavor
authors.initials: Y
authors.lastname: Bozhkov
authors.affiliation: Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nürnberg (FAU).
authors.forename: Nirjhar
authors.initials: N
authors.lastname: Hore
authors.affiliation: Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nürnberg (FAU).
authors.forename: Andreas
authors.initials: A
authors.lastname: Merkel
authors.affiliation: Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nürnberg (FAU).
authors.forename: Björn
authors.initials: B
authors.lastname: Sommer
authors.affiliation: Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nürnberg (FAU).
authors.forename: Sebastian
authors.initials: S
authors.lastname: Brandner
authors.affiliation: Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nürnberg (FAU).
authors.forename: Michael
authors.initials: M
authors.lastname: Buchfelder
authors.affiliation: Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nürnberg (FAU).
authors.forename: Nicolai E
authors.initials: NE
authors.lastname: Savaskan
authors.affiliation: Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nürnberg (FAU).
authors.forename: Ilker Y
authors.initials: IY
authors.lastname: Eyüpoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005910:Glioma / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055815:Young Adult