ArticleJournal of neurosurgery2020
Contemporary assessment of extent of resection in molecularly defined categories of diffuse low-grade glioma: a volumetric analysis.
Article in Journal of neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Congress of Neurological Surgeons systematic review and evidence-based guidelines for the role of surgery in the management of patients with diffuse low grade glioma: update.Journal of neuro-oncology · 2025Pooled it
- Malignant Progression of Diffuse Low-grade Gliomas: A Systematic Review and Meta-analysis on Incidence and Related Factors.Neurologia medico-chirurgica · 2022Pooled it
- Interactive Effects of Molecular, Therapeutic, and Patient Factors on Outcome of Diffuse Low-Grade Glioma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Association of CDKN2A/B Homozygous Deletion and Extent of Resection With Survival of Patients With WHO CNS5 Grade 4 Astrocytoma.Annals of clinical and translational neurology · 2026Article
- Lower-grade glioma imaging volumes and survival: a single-institution analysis of 90 patients after resection using intraoperative MRI.Journal of neuro-oncology · 2026Article
- Prognostic stratification of newly diagnosed IDH-mutant gliomas by [18F]fluoroethyltyrosine and [11C]methionine PET: A retrospective, bicentric cohort study.Neuro-oncology · 2025Article
- Implications of molecular classifications in glioma surgery.Journal of neuro-oncology · 2025Review
- The Role of Mutant IDH Inhibitors in the Treatment of Glioma.Current neurology and neuroscience reports · 2024Review
- Long-term autonomy, professional activities, cognition, and overall survival after awake functional-based surgery in patients with IDH-mutant grade 2 gliomas: a retrospective cohort study.The Lancet regional health. Europe · 2024Article
- The biological significance of tumor grade, age, enhancement, and extent of resection in IDH-mutant gliomas: How should they inform treatment decisions in the era of IDH inhibitors?Neuro-oncology · 2024Review
- Long-term outcomes of CNS WHO grade 2 oligodendroglioma in adult patients: a single-institution experience.Discover oncology · 2024Article
- Diagnostic accuracy of anti-3-[European journal of nuclear medicine and molecular imaging · 2024Article
- Characterization and clinical implications of different malignant transformation patterns in diffuse low-grade gliomas.Cancer science · 2023Article
- Long-term follow up of patients with WHO grade 2 oligodendroglioma.Journal of neuro-oncology · 2023Article
- Brain Plasticity Profiling as a Key Support to Therapeutic Decision-Making in Low-Grade Glioma Oncological Strategies.Cancers · 2023Review
- National-level overall survival patterns for molecularly-defined diffuse glioma types in the United States.Neuro-oncology · 2023Article
- Intraoperative detection of IDH-mutant glioma using fluorescence lifetime imaging.Journal of biophotonics · 2023Article
- Development of a Hallmark Pathway-Related Gene Signature Associated with Immune Response for Lower Grade Gliomas.International journal of molecular sciences · 2022Article
- Prognostic Factors of Low-Grade Gliomas in Adults.Current oncology (Toronto, Ont.) · 2022Article
- Preoperative [11C]methionine PET to personalize treatment decisions in patients with lower-grade gliomas.Neuro-oncology · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveWhile the effect of increased extent of resection (EOR) on survival in diffuse infiltrating low-grade glioma (LGG) patients is well established, there is still uncertainty about the influence of the new WHO molecular subtypes. The authors designed a retrospective analysis to assess the interplay between EOR and molecular classes.
methodsThe authors retrospectively reviewed the records of 326 patients treated surgically for hemispheric WHO grade II LGG at Brigham and Women's Hospital and Massachusetts General Hospital (2000-2017). EOR was calculated volumetrically and Cox proportional hazards models were built to assess for predictive factors of overall survival (OS), progression-free survival (PFS), and malignant progression-free survival (MPFS).
resultsThere were 43 deaths (13.2%; median follow-up 5.4 years) among 326 LGG patients. Median preoperative tumor volume was 31.2 cm3 (IQR 12.9-66.0), and median postoperative residual tumor volume was 5.8 cm3 (IQR 1.1-20.5). On multivariable Cox regression, increasing postoperative volume was associated with worse OS (HR 1.02 per cm3; 95% CI 1.00-1.03; p = 0.016), PFS (HR 1.01 per cm3; 95% CI 1.00-1.02; p = 0.001), and MPFS (HR 1.01 per cm3; 95% CI 1.00-1.02; p = 0.035). This result was more pronounced in the worse prognosis subtypes of IDH-mutant and IDH-wildtype astrocytoma, for which differences in survival manifested in cases with residual tumor volume of only 1 cm3. In oligodendroglioma patients, postoperative residuals impacted survival when exceeding 8 cm3. Other significant predictors of OS were age at diagnosis, IDH-mutant and IDH-wildtype astrocytoma classes, adjuvant radiotherapy, and increasing preoperative volume.
conclusionsThe results corroborate the role of EOR in survival and malignant transformation across all molecular subtypes of diffuse LGG. IDH-mutant and IDH-wildtype astrocytomas are affected even by minimal postoperative residuals and patients could potentially benefit from a more aggressive surgical approach.
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