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- Title
Extent of resection and survival for oligodendroglioma: a U.S. population-based study.
- Authors
Kinslow, Connor J.; Garton, Andrew L.A.; Rae, Ali I.; Marcus, Logan P.; Adams, Christopher M.; McKhann, Guy M.; Sisti, Michael B.; Connolly, E. Sander; Bruce, Jeffrey N.; Neugut, Alfred I.; Sonabend, Adam M.; Canoll, Peter; Cheng, Simon K.; Wang, Tony J. C.
- Abstract
Background: National guidelines recommend maximal safe resection of low-grade and high-grade oligodendrogliomas. However, there is no level 1 evidence to support these guidelines, and recent retrospective studies on the topic have yielded mixed results. Objective: To assess the association between extent of resection (EOR) and survival for oligodendrogliomas in the general U.S. population. Methods: Cases diagnosed between 2004 and 2013 were selected from the Surveillance, Epidemiology, and End-Results (SEER) Program and retrospectively analyzed for treatment, prognostic factors, and survival times. Cases that did not undergo tumor de-bulking surgery (e.g. no surgery or biopsy alone) were compared to subtotal resection (resection) and gross-total resection (GTR). The primary end-points were overall survival (OS) and cause-specific survival (CSS). An external validation cohort with 1p/19q-codeleted tumors was creating using the TCGA and GSE16011 datasets. Results: 3135 Cases were included in the final analysis. The 75% survival time (75ST) and 5-year survival rates were 47 months and 70.8%, respectively. Subtotal resection (STR, 75ST = 50 months) and GTR (75ST = 61 months) were associated with improved survival times compared to cases that did not undergo surgical debulking (75ST = 20 months, P < 0.001 for both), with reduced hazard ratios (HRs) after controlling for other factors (HR 0.81 [0.68–0.97] and HR 0.65 [0.54–0.79], respectively). GTR was associated with improved OS in both low-grade and anaplastic oligodendroglioma subgroups (HR 0.74 [0.58–0.95], HR 0.60 [0.44–0.82], respectively) while STR fell short of significance in the subgroup analysis. All findings were corroborated by multivariable analysis of CSS and externally validated in a cohort of patients with 1p19q-codeleted tumors. Conclusion: Greater EOR is associated with improved survival in oligodendrogliomas. Our findings in this U.S. population-based cohort support national guidelines.
- Subjects
TUMOR surgery
- Publication
Journal of Neuro-Oncology, 2019, Vol 144, Issue 3, p591
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-019-03261-5