Outcome predictors in a series of 40 patients after surgery for low-grade gliomas

Abstract

Objective

Low grade gliomas (LGGs) account for 15 % of primary brain tumors. The paper has the aim to identifying prognostic factors affecting overall survival (OS) and progression-free survival (PFS), and to evaluate the outcome of patients.

Methods

A total of 40 patients undergoing surgery for cerebral LGG (WHO grades I and II) at Our Institute were enrolled in the retrospective study. Inclusion criteria were: histological diagnosis of LGG, availability of complete clinical-instrumental documentation and follow-up data. For each patient, the following were analyzed: the clinical parameters in the preoperative and postoperative phases, the histological variant of the tumor, the extent of surgical resection (EOR) and any use of intraoperative methods, the Mib-1/Ki-67 proliferation index, the administration of adjuvant chemotherapy and/or radiotherapy and the occurrence of any complications.

Results

The cohort included 14 males and 26 females. The independent predictors of OS at multivariate analysis were: age, pre-operative KPS, Ki67/Mib-1, EOR and adjuvant chemotherapy. With regard to PFS, statistical significance on multivariate analysis was observed for pre-operative KPS, Ki67/Mib-1, EOR, post-operative tumor volume and radiotherapy. An EOR < 80 % was confirmed as negative prognostic factor for both OS and PFS. Lastly, the pre-operative tumor volume and the use of Intra-operative Electrophysiological Monitoring were significantly associated with EOR.

Conclusion

In this study, according to the literature, several prognostic factors determining the outcome of LGG patients, both in terms of OS and PFS, were confirmed. Knowing the impact of these parameters in terms of prognosis would guide the choice of treatment, which will necessarily be multidisciplinary and tailored.