@article{e590f775b7734235a72b11ef0a2ab17b,
title = "A Multi-Institutional Analysis of Factors Influencing Surgical Outcomes for Patients with Newly Diagnosed Grade I Gliomas",
abstract = "Objective: To assess the impact of intraoperative magnetic resonance imaging (iMRI), extent of resection (EOR), and other factors on overall survival (OS) and progression-free survival (PFS) for patients with newly diagnosed grade I gliomas. Methods: A multicenter database was queried to identify patients with grade I gliomas. Retrospective analyses assessed the impact of patient, treatment, and tumor characteristics on OS and PFS. Results: A total of 284 patients underwent treatment for grade I gliomas, including 248 resections (205 with iMRI, 43 without), 23 biopsies, and 13 laser interstitial thermal therapy treatments. Log-rank analyses of Kaplan-Meier plots showed improved 5-year OS (P = 0.0107) and PFS (P = 0.0009) with increasing EOR, and a trend toward improved 5-year OS for patients with lower American Society of Anesthesiologists score (P = 0.0528). Greater EOR was associated with significantly increased 5-year PFS for pilocytic astrocytoma (P < 0.0001), but not for ganglioglioma (P = 0.10) or dysembryoplastic neuroepithelial tumor (P = 0.57). Temporal tumors (P = 0.04) and location of “other” (P = 0.04) were associated with improved PFS, and occipital/parietal tumors (P = 0.02) were associated with decreased PFS compared with all other locations. Additional tumor resection was performed after iMRI in 49.7% of cases using iMRI, which produced gross total resection in 64% of these additional resection cases. Conclusions: Patients with grade I gliomas have extended OS and PFS, which correlates positively with increasing EOR, especially for patients with pilocytic astrocytoma. iMRI may increase EOR, indicated by the rate of gross total resection after iMRI use but was not independently associated with increased OS or PFS.",
keywords = "Clinical research, Grade I glioma, Intraoperative magnetic resonance imaging, Neurosurgery, Registry, Treatment outcomes",
author = "Yahanda, {Alexander T.} and Bhuvic Patel and Garnette Sutherland and John Honeycutt and Jensen, {Randy L.} and Smyth, {Matthew D.} and Limbrick, {David D.} and Dacey, {Ralph G.} and Dowling, {Joshua L.} and Dunn, {Gavin P.} and Kim, {Albert H.} and Leuthardt, {Eric C.} and Rich, {Keith M.} and Zipfel, {Gregory J.} and Leonard, {Jeffrey R.} and Cahill, {Daniel P.} and Shah, {Mitesh V.} and Abram, {Steven R.} and John Evans and Yu Tao and Chicoine, {Michael R.}",
note = "Funding Information: Conflict of interest statement: M.R.C. received funding from 1) IMRIS Inc. for an unrestricted educational grant to support an iMRI database and outcomes analysis project (IMRIS Multicenter intraoperative MRI Neurosurgery Database [I-MiND]), 2) The Head for the Cure Foundation, and 3) Mrs. Carol Rossfeld and The Alex & Alice Aboussie Family Charitable Foundation. The REDCap server at Washington University in St. Louis is supported by Clinical and Translational Science Award (CTSA) grant [UL1 TR000448] and The Siteman Comprehensive Cancer Center and NCI Cancer Center support grant P30 CA091842. No other authors have any relevant disclosures. None of the authors has any conflicts of interest. The authors have no personal financial or institutional interest in any of the drugs, materials, or devices described in this article. Funding Information: Conflict of interest statement: M.R.C. received funding from 1) IMRIS Inc . for an unrestricted educational grant to support an iMRI database and outcomes analysis project (IMRIS Multicenter intraoperative MRI Neurosurgery Database [I-MiND]), 2) The Head for the Cure Foundation , and 3) Mrs. Carol Rossfeld and The Alex & Alice Aboussie Family Charitable Foundation . The REDCap server at Washington University in St. Louis is supported by Clinical and Translational Science Award (CTSA) grant [ UL1 TR000448 ] and The Siteman Comprehensive Cancer Center and NCI Cancer Center support grant P30 CA091842 . No other authors have any relevant disclosures. None of the authors has any conflicts of interest. The authors have no personal financial or institutional interest in any of the drugs, materials, or devices described in this article. Publisher Copyright: {\textcopyright} 2019 Elsevier Inc.",
year = "2020",
month = mar,
doi = "10.1016/j.wneu.2019.12.156",
language = "English",
volume = "135",
pages = "e754--e764",
journal = "World Neurosurgery",
issn = "1878-8750",
}