Inter- and intrapatients comparison of WHO grade II glioma kinetics before and after surgical resection

• Published in: Neurosurgical review Vol. 33; no. 1; pp. 91 - 96
• Main Authors: Mandonnet, Emmanuel, Pallud, Johan, Fontaine, Denys, Taillandier, Luc, Bauchet, Luc, Peruzzi, Philippe, Guyotat, Jacques, Bernier, Valérie, Baron, Marie-Hélène, Duffau, Hugues, Capelle, Laurent
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.01.2010
• Subjects: Adolescent; Adult; Antineoplastic Agents, Alkylating - therapeutic use; Astrocytoma - pathology; Astrocytoma - surgery; Brain Neoplasms - pathology; Brain Neoplasms - surgery; Brain Neoplasms - therapy; Child; Dacarbazine - analogs & derivatives; Dacarbazine - therapeutic use; Databases, Factual; Disease Progression; Female; Follow-Up Studies; Glioma - pathology; Glioma - surgery; Glioma - therapy; Humans; Kinetics; Linear Models; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local; Neurosurgery; Neurosurgical Procedures; Oligodendroglioma - pathology; Oligodendroglioma - surgery; Original Article; Retrospective Studies; Young Adult; Tumor kinetics; MRI; Surgery; Tumor growth rates; WHO grade II glioma
• ISSN: 0344-5607; 1437-2320; 1437-2320
• DOI: 10.1007/s10143-009-0229-x

Grade II gliomas grow slowly and linearly (at rates about 4 mm/year) before undergoing anaplastic transformation. In order to analyze how surgery may affect radiological grade II glioma kinetics, we restrospectively reviewed our national database searching for patients operated on for a supratentorial grade II glioma between 1997 and 2007. We selected patients with at least two postoperative MRI with a minimal delay of 6 months. For each patient, postoperative residues were segmented on successive MRIs. Velocities of diameter expansion were estimated by linear regression of mean diameter evolution for each patient. Fifty-four patients fulfilled inclusion criteria. Median postoperative follow-up was 1.6 years with, on average, 3.4 MRI examinations per patient. Postoperative growth rates of mean diameter were normally distributed, around a mean value of 4.3 mm/year (SD = 3.2 mm/year). Statistical analysis showed no difference between this distribution and the distribution of preoperative growth rates in a previous series of 143 grade II gliomas. For a subset of 23 patients, delay between first MRI and surgery made it possible to estimate also preoperative growth rates. Intrapatient comparison revealed that growth rates were grossly unchanged for 80% of cases. In summary, inter- and intrapatient comparison of pre- and postoperative growth rates proves that surgery does not change grade II glioma dynamics, thus, acting as a cytoreduction.