ArticleJournal of neuro-oncology2026
Traveling large distances for awake functional-based surgery of IDH-mutated grade 2 glioma: outcomes comparison between loco-regional versus international patients.
Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe impact of long-travel distances is unknown in grade 2 glioma (G2G) patients. Here, the onco-functional outcomes following awake surgery for IDH-mutated G2G were compared between loco-regional versus international patients.
methodsG2G patients who underwent awake connectome-guided surgery and followed ≥ 1 year postoperatively were selected, with comparison across loco-regional patients (group 1) and foreigners (group 2).
resultsThis consecutive cohort comprised 284 patients (mean age: 37.4 ± 9.6 years) with seizures in 225 cases (79.2%) and a mean KPS score of 95.1 ± 6.3. The preoperative mean tumor volume was 56.1 ± 46.8cc. The postoperative mean KPS score was 94.1 ± 6.5, with 0.3% of persistent deterioration, and 214 patients resuming employment (88.8%). The mean EOR was 92.2 ± 8.3%, with a mean residual tumor volume of 5.9 ± 8.7cc. There were 162 astrocytomas (57%) and 122 oligodendrogliomas. The mean follow-up was 7.3 ± 3.9 years with a median OS > 19 years. Foreigners (n = 151) had more preoperative intractable epilepsy (p = 0.05) with a higher rate of left gliomas (p = 0.019) in insular/paralimbic location (p = 0.031), while loco-regional patients (n = 133) had more right gliomas in frontal location (p = 0.028). The EOR was similar in both groups, whereas foreigners had less supratotal resections (p = 0.034). The KPS score was better in international patients at 3 months postoperatively (p = 0.008) although there was no difference in RTW proportion and median OS (> 19 years in both groups).
conclusionThis original series demonstrates that, although international patients undergoing awake surgery for G2G may recover more quickly with less supramarginal resections, RTW rate and OS were similar. Traveling large distances is not associated with long-term onco-functional outcomes.
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