• World Neurosurg · Apr 2023

    Survival, Functional, and Seizure Control Outcomes Following Resection of Perirolandic WHO II and III Gliomas: A Single-Center Retrospective Review.

    • Hao Tan, Joseph Nugent, Caleb Nerison, Edward Ward, Stephen Bowden, and Ahmed M Raslan.
    • Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA.
    • World Neurosurg. 2023 Apr 1; 172: e165e176e165-e176.

    ObjectiveWe aimed to assess, in patients with perirolandic gliomas and gliomas originating from other regions, survival, functional outcomes, and seizure control and, in addition, to identify any clinical characteristics predictive of progression-free survival, overall survival, and seizure control.MethodsWe retrospectively analyzed 87 patients who underwent resection of World Health Organization grade II or III gliomas at a single institution between 2009 and 2021. Tumors were classified by topographic involvement. One-year postoperative functional status was quantified with Karnofsky Performance Status. One-year seizure control was defined by Engel seizure classification. Dichotomous and categorical variables were reported as counts and percentages and compared using Fisher exact test. A Cox regression model was used to identify covariates that affect progression-free survival and overall survival.ResultsPatients with perirolandic gliomas had similar survival and functional outcomes to patients with gliomas from other regions and a low rate of lasting neurologic deficits. Patients with perirolandic gliomas had comparatively worse long-term seizure outcomes (approached statistical significance). Perirolandic involvement (hazard ratio [HR], 0.10; 95% confidence interval [CI], 0.02-0.46; P = 0.005) and preoperative seizures (HR, 0.14; 95% CI, 0.02-0.62; P = 0.017) conferred a lower likelihood of durable seizure control, whereas increased extent of resection (HR, 1.07; 95% CI, 1.03-1.12; P = 0.003) enhanced the likelihood of seizure freedom.ConclusionsDespite proximity to or presence in eloquent structures, perirolandic gliomas can largely be resected without incurring worse functional outcomes. Patients with perirolandic gliomas should be considered for maximal safe resection to optimize survival outcomes and improve seizure control.Copyright © 2023 Elsevier Inc. All rights reserved.

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