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Survival rates in patients with low-grade glioma after intraoperative magnetic resonance image guidance

  1. Elizabeth B. Claus M.D., Ph.D.1,2,†,*,
  2. Andres Horlacher M.D.1,
  3. Liangge Hsu M.D.3,
  4. Richard B. Schwartz M.D.3,
  5. Donna Dello-Iacono M.S.N.1,
  6. Florian Talos M.D.3,
  7. Ferenc A. Jolesz M.D.3,
  8. Peter M. Black M.D., Ph.D.1

Article first published online: 2 FEB 2005

DOI: 10.1002/cncr.20867

Issue

Cancer

Cancer

Volume 103, Issue 6, pages 1227–1233, 15 March 2005

Additional Information

How to Cite

Claus, E. B., Horlacher, A., Hsu, L., Schwartz, R. B., Dello-Iacono, D., Talos, F., Jolesz, F. A. and Black, P. M. (2005), Survival rates in patients with low-grade glioma after intraoperative magnetic resonance image guidance. Cancer, 103: 1227–1233. doi: 10.1002/cncr.20867

Author Information

  1. 1

    Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts

  2. 2

    Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut

  3. 3

    Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts

  1. †

    Fax: (203) 785–6912

*Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, P.O. Box 208034, New Haven, CT 06520-8034

  1. †

    Fax: (203) 785–6912

Publication History

  1. Issue published online: 2 MAR 2005
  2. Article first published online: 2 FEB 2005
  3. Manuscript Accepted: 12 NOV 2004
  4. Manuscript Revised: 20 OCT 2004
  5. Manuscript Received: 27 SEP 2004

Funded by

  • National Institutes of Health. Grant Number: 5R25-CA089017-03
  • Brain Science Foundation, Boston, Massachusetts
  • Goldfine family

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Keywords:

  • low-grade glioma;
  • epidemiology;
  • survival;
  • resection;
  • neurosurgery;
  • magnetic resonance imaging

Abstract

BACKGROUND

No age-adjusted or histologic-adjusted assessments of the association between extent of resection and risk of either recurrence or death exist for neurosurgical patients who undergo resection of low-grade glioma using intraoperative magnetic resonance image (MRI) guidance.

METHODS

The current data included 156 patients who underwent surgical resection of a unifocal, supratentorial, low-grade glioma in the MRI suite at Brigham and Women's Hospital between January 1, 1997, and January 31, 2003. Estimates of disease-free and overall survival probabilities were calculated using Kaplan–Meier methodology. The association between extent of resection and these probabilities was measured using a Cox proportional hazards model. Observed death rates were compared with the expected death rate using age-specific and histologic-specific survival rates obtained from the Surveillance, Epidemiology, and End Results Registry.

RESULTS

Patients who underwent subtotal resection were at 1.4 times the risk of disease recurrence (95% confidence interval [95% CI], 0.7–3.1) and at 4.9 times the risk of death (95% CI, 0.61–40.0) relative to patients who underwent gross total resection. The 1-year, 2-year, and 5-year age-adjusted and histologic-adjusted death rates for patients who underwent surgical resection using intraoperative MRI guidance were 1.9% (95% CI, 0.3–4.2%), 3.6% (95% CI, 0.4–6.7%), and 17.6% (95% CI, 5.9–29.3%), respectively: significantly lower than the rates reported using national data bases.

CONCLUSIONS

The data from the current study suggested a possible association between surgical resection and survival for neurosurgical patients who underwent surgery for low-grade glioma under intraoperative MRI guidance. Further study within the context of a large, prospective, population-based project will be needed to confirm these findings. Cancer 2005. © 2005 American Cancer Society.

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