Long-term surgical and seizure outcomes of frontal low-grade gliomas. (September 2016)

• Record Type: Journal Article
• Authors: Tanriverdi, Taner; Kemerdere, Rahsan; Baran, Oguz; Sayyahmelli, Sima; Ozlen, Fatma; Isler, Cihan; Uzan, Mustafa; Ozyurt, Emin
• Is Part Of: International journal of surgery. Volume 33:Part A(2016)
• Page Start: 60
• Page End: 64
• Publication Date: 2016-09
• Subjects: Low-grade -- Glioma -- Frontal -- Epilepsy -- Outcome; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2016.07.065
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Introduction: Low-grade gliomas are infrequent lesions requiring special emphasis because of their relatively long follow-up time, and therefore the need for patients' well-being. Surgery provides not only increased survival but also improved quality of life for these patients. The purpose of this study was to present surgical series of frontal low-grade gliomas that were operated in our clinic and to discuss their epileptic and functional outcomes. Methods: A series of 40 patients with low-grade glioma (WHO Grade II) were retrospectively analysed for patient characteristics, tumour location, epileptic history, surgery type (awake craniotomy, general anaesthesia), extent of resection and complications. Results: Tumour was localized to primary motor area in most of the cases (35%, n = 14), 25 patients were operated under general anaesthesia and 15 with awake craniotomy. New deficit rate in the early postoperative period was 32.5% (dysarthria in one patient and motor deficits in 12). Karnofsky scores were ≥90 in 92.5% of the patients at the late follow-up. 31 patients were Engel I (77.5%), 5 were Engel II (12.5%) and 4 were Engel IV (10%) postoperatively. Conclusion: Frontal LGGs are eligible to resect vigorously without persistent functional deficits. Patients with immediate postoperative complications benefit from neuro-rehabilitation. However, pre-existing speech dysfunctions are hard to recover with surgery. Surgical resection ends with favourable epileptic outcomes whereas tumour location may influence the results. Highlights: Seizure is the most common symptom in frontal low-grade gliomas. Duration of epilepsy and extent of resection are predictors of seizure outcome. Patients with worse seizure outcomes have tumour in the primary motor area. Patients with frontal low-grade gliomas benefit from postoperative rehabilitation.