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Interactive Effects...
Interactive Effects of Molecular, Therapeutic, and Patient Factors on Outcome of Diffuse Low-Grade Glioma.
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Hervey-Jumper, Shawn L (author)
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Zhang, Yalan (author)
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Phillips, Joanna J (author)
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Morshed, Ramin A (author)
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Young, Jacob S (author)
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McCoy, Lucie (author)
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Lafontaine, Marisa (author)
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Luks, Tracy (author)
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Ammanuel, Simon (author)
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Kakaizada, Sofia (author)
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Egladyous, Andrew (author)
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Gogos, Andrew (author)
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Villanueva-Meyer, Javier (author)
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Shai, Anny (author)
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Warrier, Gayathri (author)
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Rice, Terri (author)
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Crane, Jason (author)
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Wrensch, Margaret (author)
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Wiencke, John K (author)
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Daras, Mariza (author)
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Oberheim Bush, Nancy Ann (author)
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Taylor, Jennie W (author)
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Butowski, Nicholas (author)
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Clarke, Jennifer (author)
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Chang, Susan (author)
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Chang, Edward (author)
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Aghi, Manish (author)
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Theodosopoulos, Philip (author)
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McDermott, Michael (author)
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- Jakola, Asgeir Store (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
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Kavouridis, Vasileios K (author)
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Nawabi, Noah (author)
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Solheim, Ole (author)
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Smith, Timothy (author)
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Berger, Mitchel S (author)
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Molinaro, Annette M (author)
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(creator_code:org_t)
- 2023
- 2023
- English.
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In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. - 1527-7755. ; 41:11, s. 2029-2042
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https://doi.org/10.1...
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Abstract
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- In patients with diffuse low-grade glioma (LGG), the extent of surgical tumor resection (EOR) has a controversial role, in part because a randomized clinical trial with different levels of EOR is not feasible.In a 20-year retrospective cohort of 392 patients with IDH-mutant grade 2 glioma, we analyzed the combined effects of volumetric EOR and molecular and clinical factors on overall survival (OS) and progression-free survival by recursive partitioning analysis. The OS results were validated in two external cohorts (n = 365). Propensity score analysis of the combined cohorts (n = 757) was used to mimic a randomized clinical trial with varying levels of EOR.Recursive partitioning analysis identified three survival risk groups. Median OS was shortest in two subsets of patients with astrocytoma: those with postoperative tumor volume (TV) > 4.6 mL and those with preoperative TV > 43.1 mL and postoperative TV ≤ 4.6 mL. Intermediate OS was seen in patients with astrocytoma who had chemotherapy with preoperative TV ≤ 43.1 mL and postoperative TV ≤ 4.6 mL in addition to oligodendroglioma patients with either preoperative TV > 43.1 mL and residual TV ≤ 4.6 mL or postoperative residual volume > 4.6 mL. Longest OS was seen in astrocytoma patients with preoperative TV ≤ 43.1 mL and postoperative TV ≤ 4.6 mL who received no chemotherapy and oligodendroglioma patients with preoperative TV ≤ 43.1 mL and postoperative TV ≤ 4.6 mL. EOR ≥ 75% improved survival outcomes, as shown by propensity score analysis.Across both subtypes of LGG, EOR beginning at 75% improves OS while beginning at 80% improves progression-free survival. Nonetheless, maximal resection with preservation of neurological function remains the treatment goal. Our findings have implications for surgical strategies for LGGs, particularly oligodendroglioma.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
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- ref (subject category)
- art (subject category)
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- By the author/editor
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Hervey-Jumper, S ...
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Zhang, Yalan
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Phillips, Joanna ...
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Morshed, Ramin A
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Young, Jacob S
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McCoy, Lucie
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show more...
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Lafontaine, Mari ...
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Luks, Tracy
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Ammanuel, Simon
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Kakaizada, Sofia
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Egladyous, Andre ...
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Gogos, Andrew
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Villanueva-Meyer ...
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Shai, Anny
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Warrier, Gayathr ...
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Rice, Terri
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Crane, Jason
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Wrensch, Margare ...
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Wiencke, John K
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Daras, Mariza
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Oberheim Bush, N ...
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Taylor, Jennie W
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Butowski, Nichol ...
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Clarke, Jennifer
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Chang, Susan
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Chang, Edward
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Aghi, Manish
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Theodosopoulos, ...
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McDermott, Micha ...
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Jakola, Asgeir S ...
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Kavouridis, Vasi ...
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Nawabi, Noah
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Solheim, Ole
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Smith, Timothy
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Berger, Mitchel ...
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Molinaro, Annett ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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Journal of clini ...
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University of Gothenburg