title: Putamen involvement and survival outcomes in patients with insular low-grade gliomas.
abstract: OBJECTIVE Insular glioma has a unique origin and biological behavior; however, the associations between its anatomical features and prognosis have not been well established. The object of this study was to propose a classification system of insular low-grade gliomas based on preoperative MRI findings and to assess the system's association with survival outcome. METHODS A total of 211 consecutively collected patients diagnosed with low-grade insular gliomas was analyzed. All patients were classified according to whether tumor involved the putamen on MR images. The prognostic role of this novel putaminal classification, as well as that of Yaşargil's classification, was examined using multivariate analyses. RESULTS Ninety-nine cases (46.9%) of insular gliomas involved the putamen. Those tumors involving the putamen, as compared with nonputaminal tumors, were larger (p < 0.001), less likely to be associated with a history of seizures (p = 0.04), more likely to have wild-type IDH1 (p = 0.003), and less likely to be totally removed (p = 0.02). Significant favorable predictors of overall survival on univariate analysis included a high preoperative Karnofsky Performance Scale score (p = 0.02), a history of seizures (p = 0.04), gross-total resection (p = 0.006), nonputaminal tumors (p < 0.001), and an IDH1 mutation (p < 0.001). On multivariate analysis, extent of resection (p = 0.035), putamen classification (p = 0.014), and IDH1 mutation (p = 0.026) were independent predictors of overall survival. No prognostic role was found for Yaşargil's classification. CONCLUSIONS The current study's findings suggest that the putamen classification is an independent predictor of survival outcome in patients with insular low-grade gliomas. This newly proposed classification allows preoperative survival prediction for patients with insular gliomas.
authors: Beijing Neurosurgical Institute, Capital Medical University;
authors: Yongheng
authors: Y
authors: Wang
authors: Beijing Neurosurgical Institute, Capital Medical University;|Departments of 2 Neurosurgery and.
authors: Yinyan
authors: Y
authors: Wang
authors: Beijing Neurosurgical Institute, Capital Medical University;|Neuroradiology, Beijing Tiantan Hospital, Capital Medical University; and.
authors: Xing
authors: X
authors: Fan
authors: Beijing Neurosurgical Institute, Capital Medical University;|Neuroradiology, Beijing Tiantan Hospital, Capital Medical University; and.
authors: Shaowu
authors: S
authors: Li
authors: Beijing Neurosurgical Institute, Capital Medical University;|Neuroradiology, Beijing Tiantan Hospital, Capital Medical University; and.
authors: Xing
authors: X
authors: Liu
authors: Departments of 2 Neurosurgery and.
authors: Jiangfei
authors: J
authors: Wang
authors: Beijing Neurosurgical Institute, Capital Medical University;|Departments of 2 Neurosurgery and.|Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
authors: Tao
authors: T
authors: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011699:Putamen / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
keywords: KPS = Karnofsky Performance Scale; LGG = low-grade glioma; OS = overall survival; PCR = polymerase chain reaction; PFS = progression-free survival; classification; insular glioma; oncology; prognosis; putamen