• Nan Zhang, Zhengda Yu, Hameed N U Farrukh NUF Glioma Surgery Division, Neurological Surgery Department of Huashan Hospital, Fudan University, Shanghai, China., Geng Xu, Yanyan Song, Bin Wu, Jie Zhang, Tianming Qiu, Dongxiao Zhuang, Junfeng Lu, and Jinsong Wu.
• Glioma Surgery Division, Neurological Surgery Department of Huashan Hospital, Fudan University, Shanghai, China.
• World Neurosurg. 2018 Nov 1; 119: e94-e105.

ObjectiveTo evaluate long-term functional and survival outcomes of patients with glioma after intraoperative neurophysiologic monitoring (IONM) application.MethodsA total of 856 patients with glioma, who underwent tumor resection between October 2010 and March 2016, were included in this retrospective cohort study. All patients were stratified into IONM (439 patients) and non-IONM groups (417 patients). The primary outcome measured was overall survival (OS), and the secondary outcome measured was rate of late neurologic deficits. Analyses were performed using univariate tests and multivariate logistic regression and Cox proportional hazard model.ResultsThe 2 cohorts were well balanced with respect to baseline characteristics. Univariate survival analysis showed longer OS in the IONM group than that in the non-IONM group (P = 0.036), especially in patients with high-grade astrocytic tumor (P = 0.034). The IONM group showed a lower rate of neurologic deficits than did the non-IONM group. Multivariate analysis showed that IONM was a favorable factor of OS (odds ratio, 0.776; P = 0.046) and late neurologic function (odds ratio, 0.583; P = 0.039). Dominant hemispheric and eloquent location of glioma had no association with OS.ConclusionsApplication of IONM is beneficial to long-term functional and oncologic outcomes of patients with glioma.Copyright © 2018 Elsevier Inc. All rights reserved.

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