{"title":"异柠檬酸脱氢酶突变的成人3级胶质瘤根治性清醒切除后的观察等待方法与辅助治疗：一个病例匹配的队列。","authors":"Angela Elia, Alexandre Roux, Bénédicte Trancart, Alessandro Moiraghi, Maimiti Seneca, Edouard Dezamis, Pascale Varlet, Fabrice Chretien, Catherine Oppenheim, Marc Zanello, Johan Pallud","doi":"10.1093/noajnl/vdae189","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Following large resection, proposing a watch-and-wait strategy in selected grade 3 glioma, <i>isocitrate dehydrogenase</i> (<i>IDH)</i>-mutant patients is an emerging practice. We compared the watch-and-wait approach to the standard postoperative adjuvant oncological treatment for grade 3 gliomas, <i>IDH</i>-mutant.</p><p><strong>Methods: </strong>Observational, retrospective, single-institution cohort (2011-2023) of 106 consecutive adult patients harboring supratentorial grade 3 gliomas, <i>IDH</i>-mutant treated by maximal awake resection and who received a watch-and-wait approach (surgery group) or an adjuvant oncological treatment (oncological group) postoperatively. Case-matched analysis (1:1) criteria between the surgery group and oncological group: extent of resection, tumor volume, Karnofsky Performance Status (KPS) score, tumor location and size, and age.</p><p><strong>Results: </strong>Patients of the surgery group (<i>n</i> = 26) had significantly better KPS scores, less preoperative neurological and/or neurocognitive deficits, less hyperperfusion, less corpus callosum infiltration, smaller tumor volume, higher rate of total resection, and smaller residual tumor than patients of the oncological group (<i>n</i> = 80). The 5-year progression-free survival (66.2 vs. 77.9 months, <i>P</i> = .713) and the 5-year overall survival (88.9 vs. 83.9 months, <i>P</i> = .291) did not differ between surgery and oncological groups. In the whole series, a preoperative KPS score >70, a total resection, and the oligodendroglioma subtype were independent predictors of longer progression-free survival and overall survival. After case matching, no difference in survival was observed between watch-and-wait and oncological treatment both in astrocytomas (<i>n</i> = 14 per group) and oligodendrogliomas (<i>n</i> = 12 per group).</p><p><strong>Conclusions: </strong>Watch-and-wait following radical resection appears to be feasible in highly selected grade 3 gliomas, <i>IDH</i>-mutant patients without impairing survival both in astrocytoma and in oligodendroglioma subgroups.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"6 1","pages":"vdae189"},"PeriodicalIF":3.7000,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606645/pdf/","citationCount":"0","resultStr":"{\"title\":\"Watch-and-wait approach versus adjuvant treatment after radical awake resection in selected adult-type grade 3 gliomas, <i>isocitrate dehydrogenase</i> mutant: A case-matched cohort.\",\"authors\":\"Angela Elia, Alexandre Roux, Bénédicte Trancart, Alessandro Moiraghi, Maimiti Seneca, Edouard Dezamis, Pascale Varlet, Fabrice Chretien, Catherine Oppenheim, Marc Zanello, Johan Pallud\",\"doi\":\"10.1093/noajnl/vdae189\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Following large resection, proposing a watch-and-wait strategy in selected grade 3 glioma, <i>isocitrate dehydrogenase</i> (<i>IDH)</i>-mutant patients is an emerging practice. We compared the watch-and-wait approach to the standard postoperative adjuvant oncological treatment for grade 3 gliomas, <i>IDH</i>-mutant.</p><p><strong>Methods: </strong>Observational, retrospective, single-institution cohort (2011-2023) of 106 consecutive adult patients harboring supratentorial grade 3 gliomas, <i>IDH</i>-mutant treated by maximal awake resection and who received a watch-and-wait approach (surgery group) or an adjuvant oncological treatment (oncological group) postoperatively. Case-matched analysis (1:1) criteria between the surgery group and oncological group: extent of resection, tumor volume, Karnofsky Performance Status (KPS) score, tumor location and size, and age.</p><p><strong>Results: </strong>Patients of the surgery group (<i>n</i> = 26) had significantly better KPS scores, less preoperative neurological and/or neurocognitive deficits, less hyperperfusion, less corpus callosum infiltration, smaller tumor volume, higher rate of total resection, and smaller residual tumor than patients of the oncological group (<i>n</i> = 80). The 5-year progression-free survival (66.2 vs. 77.9 months, <i>P</i> = .713) and the 5-year overall survival (88.9 vs. 83.9 months, <i>P</i> = .291) did not differ between surgery and oncological groups. In the whole series, a preoperative KPS score >70, a total resection, and the oligodendroglioma subtype were independent predictors of longer progression-free survival and overall survival. After case matching, no difference in survival was observed between watch-and-wait and oncological treatment both in astrocytomas (<i>n</i> = 14 per group) and oligodendrogliomas (<i>n</i> = 12 per group).</p><p><strong>Conclusions: </strong>Watch-and-wait following radical resection appears to be feasible in highly selected grade 3 gliomas, <i>IDH</i>-mutant patients without impairing survival both in astrocytoma and in oligodendroglioma subgroups.</p>\",\"PeriodicalId\":94157,\"journal\":{\"name\":\"Neuro-oncology advances\",\"volume\":\"6 1\",\"pages\":\"vdae189\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-11-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606645/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuro-oncology advances\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/noajnl/vdae189\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuro-oncology advances","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/noajnl/vdae189","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Watch-and-wait approach versus adjuvant treatment after radical awake resection in selected adult-type grade 3 gliomas, isocitrate dehydrogenase mutant: A case-matched cohort.
Background: Following large resection, proposing a watch-and-wait strategy in selected grade 3 glioma, isocitrate dehydrogenase (IDH)-mutant patients is an emerging practice. We compared the watch-and-wait approach to the standard postoperative adjuvant oncological treatment for grade 3 gliomas, IDH-mutant.
Methods: Observational, retrospective, single-institution cohort (2011-2023) of 106 consecutive adult patients harboring supratentorial grade 3 gliomas, IDH-mutant treated by maximal awake resection and who received a watch-and-wait approach (surgery group) or an adjuvant oncological treatment (oncological group) postoperatively. Case-matched analysis (1:1) criteria between the surgery group and oncological group: extent of resection, tumor volume, Karnofsky Performance Status (KPS) score, tumor location and size, and age.
Results: Patients of the surgery group (n = 26) had significantly better KPS scores, less preoperative neurological and/or neurocognitive deficits, less hyperperfusion, less corpus callosum infiltration, smaller tumor volume, higher rate of total resection, and smaller residual tumor than patients of the oncological group (n = 80). The 5-year progression-free survival (66.2 vs. 77.9 months, P = .713) and the 5-year overall survival (88.9 vs. 83.9 months, P = .291) did not differ between surgery and oncological groups. In the whole series, a preoperative KPS score >70, a total resection, and the oligodendroglioma subtype were independent predictors of longer progression-free survival and overall survival. After case matching, no difference in survival was observed between watch-and-wait and oncological treatment both in astrocytomas (n = 14 per group) and oligodendrogliomas (n = 12 per group).
Conclusions: Watch-and-wait following radical resection appears to be feasible in highly selected grade 3 gliomas, IDH-mutant patients without impairing survival both in astrocytoma and in oligodendroglioma subgroups.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
