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DOI: 10.1055/s-0043-1776283
Factors Related to the Recurrence of Low-grade Gliomas
Fatores relacionados à recorrência dos gliomas de baixo grauAbstract
Objective To identify the determining factors for reoperation in patients with low-grade gliomas, taking into account the degree of resection, and to analyze the histological aspects, observing possible transformations with signs of malignancy in the tissue samples.
Materials and Methods The sample consisted of 40 cases of low-grade glioma that were operated on at Hospital das Clínicas de Botucatu between 2013 and 2019.
Results The mean follow-up was of 37 months, and the sample was composed of 28 men and 12 women with a mean age at the first surgery of 43.1 ± 15.6 years. Epileptic seizures were observed in 31 (77.5%) patients. According to the histological classification, half of the patients presented oligodendroglioma (50%), of grade II in most cases (97.5%). Total or subtotal resection was achieved in 22 (55%) patients. Only one patient underwent radiotherapy, and two underwent chemotherapy. Reoperation was performed in 20 (50%) patients. The median interval between the first surgery and the reapproach was of 16 (range: 0–77) months. In the second approach, the histological classification was of astrocytoma in 4 (20%) cases, oligoastrocytoma in another 4 (20%), oligodendroglioma in 7 (35%), and glioblastoma in 5 (25%) cases. The only variable associated with the need for reoperation was the degree of resection after the first surgery (p = 0.013).
Conclusions Total resection of low-grade gliomas, when feasible, should be performed to avoid recurrence.
Resumo
Objetivo Apontar os fatores determinantes para a reoperação em pacientes com gliomas de baixo grau considerando o grau de ressecção, e analisar os aspectos histológicos, observando possíveis transformações com sinais de malignidade nas amostras teciduais estudadas.
Materiais e Métodos A casuística foi composta por 40 casos de gliomas de baixo grau operados no Hospital das Clínicas de Botucatu de 2013 a 2019.
Resultados O tempo médio de seguimento de foi de 37 meses, sendo a amostra composta de 28 homens e 12 mulheres com idade média à primeira cirurgia de 43,1 ± 15,6 anos. Crises epilépticas foram observadas em 31 pacientes (77,5%). Na classificação histológica, a metade dos pacientes apresentou oligodendroglioma (50%), sendo de grau II na maioria dos casos (97,5%). Ressecção total ou subtotal foi atingida 22 pacientes (55%). Apenas um paciente foi submetido a radioterapia, e dois, a quimioterapia. Reoperação foi realizada em 20 pacientes (50%). O intervalo mediano entre a primeira cirurgia e a reabordagem foi de 16 (variação: 0–77) meses; na segunda abordagem, a classificação histológica foi de astrocitoma em 4 casos (20%), oligoastrocitoma em outros 4 (20%), oligodendroglioma em 7 casos (35%), e glioblastoma em 5 casos (25%). A única variável que apresentou associação com a necessidade de reoperação foi o grau de ressecção da primeira cirurgia (p = 0,013).
Conclusão A ressecção total dos gliomas de baixo grau, quando factível, deve ser buscada com a finalidade de evitar a sua recorrência.
Publication History
Received: 22 September 2022
Accepted: 07 March 2023
Article published online:
27 October 2023
© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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