Cen Eur Neurosurg 2011; 72(4): 186-191
DOI: 10.1055/s-0031-1275351
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Management of Patients With Low-Grade Gliomas – A Survey Among German Neurosurgical Departments

M. Seiz1,2 , C. F. Freyschlag1,2 , S. Schenkel1 , C. Weiss3 , C. Thomé1,2 , K. Schmieder1 , W. Stummer4 , J. Tuettenberg1,5
  • 1University Medical Center Mannheim, Department of Neurosurgery, Mannheim, Germany
  • 2Innsbruck Medical University, Department of Neurosurgery, Innsbruck, Austria
  • 3University Medical Center Mannheim, Department of Biomedical Statistics, Mannheim, Germany
  • 4Department of Neurosurgery Westfälische – Wilhelms Universität, Münster, Germany
  • 5Klinikum Idar-Oberstein GmbH, Klinik für Neurochirurgie, Idar-Oberstein, Germany
Further Information

Publication History

Publication Date:
13 May 2011 (eFirst)

Abstract

Background and aims of the study: The diagnosis and treatment of low-grade gliomas (LGG) are multimodal. Today, there is no defined standard in diagnosis and treatment. Controversies are, in general, about a “wait-and-see” strategy, diagnostic workup, surgical intervention, postoperative imaging, adjuvant treatment, and follow-up. The aim of this study is to gain an overview about management strategies of high-volume German neurosurgical departments treating these patients.

Material and Methods: A questionnaire including diagnostic, preoperative, perioperative, and postoperative parameters and 5 cases with magnetic resonance imaging data with questions to various treatment options in these patients was sent to all 34 German neurosurgical departments at university hospitals.

Results: In total, 24 questionnaires were returned and analysed. Centres were divided into those who generally practice a “wait-and-see” strategy vs. those who do not or only in highly selected cases. Statistical analyses were performed with Fisher test and Chi2-test. Interestingly, 50% of all centres routinely follow a “wait-and-see” strategy.

Conclusion: Although the management of patients with LGG is complex and a simple questionnaire will not be able to define a standard in diagnosis and treatment, this study offers an overview on strategies at high-volume academic centres dealing with these patients. There is consensus to resect superficially located lobar and circumscribed low-grade lesions. However, the differences between centres become apparent with increasing complexity of the lesions.