Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry

Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p<0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p < 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG>0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Jan Coburger [verfasserIn] Julia Onken [verfasserIn] Stefan Rueckriegel [verfasserIn] Christian von der Brelie [verfasserIn] Minou Nadji-Ohl [verfasserIn] Marie-Therese Forster [verfasserIn] Rüdiger Gerlach [verfasserIn] Meike Unteroberdörster [verfasserIn] Constantin Roder [verfasserIn] Katja Kniese [verfasserIn] Stefan Schommer [verfasserIn] Dietrich Rothenbacher [verfasserIn] Gabriele Nagel [verfasserIn] Christian Rainer Wirtz [verfasserIn] Ralf-Ingo Ernestus [verfasserIn] Arya Nabavi [verfasserIn] Marcos Tatagiba [verfasserIn] Marcus Czabanka [verfasserIn] Oliver Ganslandt [verfasserIn] Veit Rohde [verfasserIn] Mario Löhr [verfasserIn] Peter Vajkoczy [verfasserIn] Andrej Pala [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	LGG neurological deficit awake surgery iMRI = intraoperative MRI iUS = intraoperative ultrasound intraoperative monitoring (IOM)

Übergeordnetes Werk:	In: Frontiers in Oncology - Frontiers Media S.A., 2012, 12(2022)
Übergeordnetes Werk:	volume:12 ; year:2022

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3389/fonc.2022.845992

Katalog-ID:	DOAJ04142834X

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700	0		\|a Julia Onken \|e verfasserin \|4 aut
700	0		\|a Stefan Rueckriegel \|e verfasserin \|4 aut
700	0		\|a Christian von der Brelie \|e verfasserin \|4 aut
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700	0		\|a Constantin Roder \|e verfasserin \|4 aut
700	0		\|a Katja Kniese \|e verfasserin \|4 aut
700	0		\|a Stefan Schommer \|e verfasserin \|4 aut
700	0		\|a Dietrich Rothenbacher \|e verfasserin \|4 aut
700	0		\|a Gabriele Nagel \|e verfasserin \|4 aut
700	0		\|a Christian Rainer Wirtz \|e verfasserin \|4 aut
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allfields	10.3389/fonc.2022.845992 doi (DE-627)DOAJ04142834X (DE-599)DOAJ5c0492d198504cf0b65a41a66cdd902e DE-627 ger DE-627 rakwb eng RC254-282 Jan Coburger verfasserin aut Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p<0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p < 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG>0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia. LGG neurological deficit awake surgery iMRI = intraoperative MRI iUS = intraoperative ultrasound intraoperative monitoring (IOM) Neoplasms. Tumors. Oncology. Including cancer and carcinogens Julia Onken verfasserin aut Stefan Rueckriegel verfasserin aut Christian von der Brelie verfasserin aut Minou Nadji-Ohl verfasserin aut Marie-Therese Forster verfasserin aut Rüdiger Gerlach verfasserin aut Meike Unteroberdörster verfasserin aut Constantin Roder verfasserin aut Katja Kniese verfasserin aut Stefan Schommer verfasserin aut Dietrich Rothenbacher verfasserin aut Gabriele Nagel verfasserin aut Christian Rainer Wirtz verfasserin aut Ralf-Ingo Ernestus verfasserin aut Arya Nabavi verfasserin aut Marcos Tatagiba verfasserin aut Marcus Czabanka verfasserin aut Oliver Ganslandt verfasserin aut Veit Rohde verfasserin aut Mario Löhr verfasserin aut Peter Vajkoczy verfasserin aut Andrej Pala verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 12(2022) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:12 year:2022 https://doi.org/10.3389/fonc.2022.845992 kostenfrei https://doaj.org/article/5c0492d198504cf0b65a41a66cdd902e kostenfrei https://www.frontiersin.org/articles/10.3389/fonc.2022.845992/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022
spelling	10.3389/fonc.2022.845992 doi (DE-627)DOAJ04142834X (DE-599)DOAJ5c0492d198504cf0b65a41a66cdd902e DE-627 ger DE-627 rakwb eng RC254-282 Jan Coburger verfasserin aut Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p<0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p < 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG>0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia. LGG neurological deficit awake surgery iMRI = intraoperative MRI iUS = intraoperative ultrasound intraoperative monitoring (IOM) Neoplasms. Tumors. Oncology. Including cancer and carcinogens Julia Onken verfasserin aut Stefan Rueckriegel verfasserin aut Christian von der Brelie verfasserin aut Minou Nadji-Ohl verfasserin aut Marie-Therese Forster verfasserin aut Rüdiger Gerlach verfasserin aut Meike Unteroberdörster verfasserin aut Constantin Roder verfasserin aut Katja Kniese verfasserin aut Stefan Schommer verfasserin aut Dietrich Rothenbacher verfasserin aut Gabriele Nagel verfasserin aut Christian Rainer Wirtz verfasserin aut Ralf-Ingo Ernestus verfasserin aut Arya Nabavi verfasserin aut Marcos Tatagiba verfasserin aut Marcus Czabanka verfasserin aut Oliver Ganslandt verfasserin aut Veit Rohde verfasserin aut Mario Löhr verfasserin aut Peter Vajkoczy verfasserin aut Andrej Pala verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 12(2022) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:12 year:2022 https://doi.org/10.3389/fonc.2022.845992 kostenfrei https://doaj.org/article/5c0492d198504cf0b65a41a66cdd902e kostenfrei https://www.frontiersin.org/articles/10.3389/fonc.2022.845992/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022
allfields_unstemmed	10.3389/fonc.2022.845992 doi (DE-627)DOAJ04142834X (DE-599)DOAJ5c0492d198504cf0b65a41a66cdd902e DE-627 ger DE-627 rakwb eng RC254-282 Jan Coburger verfasserin aut Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p<0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p < 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG>0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia. LGG neurological deficit awake surgery iMRI = intraoperative MRI iUS = intraoperative ultrasound intraoperative monitoring (IOM) Neoplasms. Tumors. Oncology. Including cancer and carcinogens Julia Onken verfasserin aut Stefan Rueckriegel verfasserin aut Christian von der Brelie verfasserin aut Minou Nadji-Ohl verfasserin aut Marie-Therese Forster verfasserin aut Rüdiger Gerlach verfasserin aut Meike Unteroberdörster verfasserin aut Constantin Roder verfasserin aut Katja Kniese verfasserin aut Stefan Schommer verfasserin aut Dietrich Rothenbacher verfasserin aut Gabriele Nagel verfasserin aut Christian Rainer Wirtz verfasserin aut Ralf-Ingo Ernestus verfasserin aut Arya Nabavi verfasserin aut Marcos Tatagiba verfasserin aut Marcus Czabanka verfasserin aut Oliver Ganslandt verfasserin aut Veit Rohde verfasserin aut Mario Löhr verfasserin aut Peter Vajkoczy verfasserin aut Andrej Pala verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 12(2022) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:12 year:2022 https://doi.org/10.3389/fonc.2022.845992 kostenfrei https://doaj.org/article/5c0492d198504cf0b65a41a66cdd902e kostenfrei https://www.frontiersin.org/articles/10.3389/fonc.2022.845992/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022
allfieldsGer	10.3389/fonc.2022.845992 doi (DE-627)DOAJ04142834X (DE-599)DOAJ5c0492d198504cf0b65a41a66cdd902e DE-627 ger DE-627 rakwb eng RC254-282 Jan Coburger verfasserin aut Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p<0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p < 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG>0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia. LGG neurological deficit awake surgery iMRI = intraoperative MRI iUS = intraoperative ultrasound intraoperative monitoring (IOM) Neoplasms. Tumors. Oncology. Including cancer and carcinogens Julia Onken verfasserin aut Stefan Rueckriegel verfasserin aut Christian von der Brelie verfasserin aut Minou Nadji-Ohl verfasserin aut Marie-Therese Forster verfasserin aut Rüdiger Gerlach verfasserin aut Meike Unteroberdörster verfasserin aut Constantin Roder verfasserin aut Katja Kniese verfasserin aut Stefan Schommer verfasserin aut Dietrich Rothenbacher verfasserin aut Gabriele Nagel verfasserin aut Christian Rainer Wirtz verfasserin aut Ralf-Ingo Ernestus verfasserin aut Arya Nabavi verfasserin aut Marcos Tatagiba verfasserin aut Marcus Czabanka verfasserin aut Oliver Ganslandt verfasserin aut Veit Rohde verfasserin aut Mario Löhr verfasserin aut Peter Vajkoczy verfasserin aut Andrej Pala verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 12(2022) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:12 year:2022 https://doi.org/10.3389/fonc.2022.845992 kostenfrei https://doaj.org/article/5c0492d198504cf0b65a41a66cdd902e kostenfrei https://www.frontiersin.org/articles/10.3389/fonc.2022.845992/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022
allfieldsSound	10.3389/fonc.2022.845992 doi (DE-627)DOAJ04142834X (DE-599)DOAJ5c0492d198504cf0b65a41a66cdd902e DE-627 ger DE-627 rakwb eng RC254-282 Jan Coburger verfasserin aut Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p<0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p < 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG>0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia. LGG neurological deficit awake surgery iMRI = intraoperative MRI iUS = intraoperative ultrasound intraoperative monitoring (IOM) Neoplasms. Tumors. Oncology. Including cancer and carcinogens Julia Onken verfasserin aut Stefan Rueckriegel verfasserin aut Christian von der Brelie verfasserin aut Minou Nadji-Ohl verfasserin aut Marie-Therese Forster verfasserin aut Rüdiger Gerlach verfasserin aut Meike Unteroberdörster verfasserin aut Constantin Roder verfasserin aut Katja Kniese verfasserin aut Stefan Schommer verfasserin aut Dietrich Rothenbacher verfasserin aut Gabriele Nagel verfasserin aut Christian Rainer Wirtz verfasserin aut Ralf-Ingo Ernestus verfasserin aut Arya Nabavi verfasserin aut Marcos Tatagiba verfasserin aut Marcus Czabanka verfasserin aut Oliver Ganslandt verfasserin aut Veit Rohde verfasserin aut Mario Löhr verfasserin aut Peter Vajkoczy verfasserin aut Andrej Pala verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 12(2022) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:12 year:2022 https://doi.org/10.3389/fonc.2022.845992 kostenfrei https://doaj.org/article/5c0492d198504cf0b65a41a66cdd902e kostenfrei https://www.frontiersin.org/articles/10.3389/fonc.2022.845992/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022
language	English
source	In Frontiers in Oncology 12(2022) volume:12 year:2022
sourceStr	In Frontiers in Oncology 12(2022) volume:12 year:2022
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	LGG neurological deficit awake surgery iMRI = intraoperative MRI iUS = intraoperative ultrasound intraoperative monitoring (IOM) Neoplasms. Tumors. Oncology. Including cancer and carcinogens
isfreeaccess_bool	true
container_title	Frontiers in Oncology
authorswithroles_txt_mv	Jan Coburger @@aut@@ Julia Onken @@aut@@ Stefan Rueckriegel @@aut@@ Christian von der Brelie @@aut@@ Minou Nadji-Ohl @@aut@@ Marie-Therese Forster @@aut@@ Rüdiger Gerlach @@aut@@ Meike Unteroberdörster @@aut@@ Constantin Roder @@aut@@ Katja Kniese @@aut@@ Stefan Schommer @@aut@@ Dietrich Rothenbacher @@aut@@ Gabriele Nagel @@aut@@ Christian Rainer Wirtz @@aut@@ Ralf-Ingo Ernestus @@aut@@ Arya Nabavi @@aut@@ Marcos Tatagiba @@aut@@ Marcus Czabanka @@aut@@ Oliver Ganslandt @@aut@@ Veit Rohde @@aut@@ Mario Löhr @@aut@@ Peter Vajkoczy @@aut@@ Andrej Pala @@aut@@
publishDateDaySort_date	2022-01-01T00:00:00Z
hierarchy_top_id	684965518
id	DOAJ04142834X
language_de	englisch
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Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p&lt;0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p &lt; 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG&gt;0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. 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callnumber-first	R - Medicine
author	Jan Coburger
spellingShingle	Jan Coburger misc RC254-282 misc LGG misc neurological deficit misc awake surgery misc iMRI = intraoperative MRI misc iUS = intraoperative ultrasound misc intraoperative monitoring (IOM) misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry
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topic_title	RC254-282 Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry LGG neurological deficit awake surgery iMRI = intraoperative MRI iUS = intraoperative ultrasound intraoperative monitoring (IOM)
topic	misc RC254-282 misc LGG misc neurological deficit misc awake surgery misc iMRI = intraoperative MRI misc iUS = intraoperative ultrasound misc intraoperative monitoring (IOM) misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
topic_unstemmed	misc RC254-282 misc LGG misc neurological deficit misc awake surgery misc iMRI = intraoperative MRI misc iUS = intraoperative ultrasound misc intraoperative monitoring (IOM) misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
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title	Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry
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title_full	Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry
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author_browse	Jan Coburger Julia Onken Stefan Rueckriegel Christian von der Brelie Minou Nadji-Ohl Marie-Therese Forster Rüdiger Gerlach Meike Unteroberdörster Constantin Roder Katja Kniese Stefan Schommer Dietrich Rothenbacher Gabriele Nagel Christian Rainer Wirtz Ralf-Ingo Ernestus Arya Nabavi Marcos Tatagiba Marcus Czabanka Oliver Ganslandt Veit Rohde Mario Löhr Peter Vajkoczy Andrej Pala
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title_sort	eloquent lower grade gliomas, a highly vulnerable cohort: assessment of patients’ functional outcome after surgery based on the log-glio registry
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title_auth	Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry
abstract	Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p<0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p < 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG>0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia.
abstractGer	Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p<0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p < 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG>0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia.
abstract_unstemmed	Majority of lower grade glioma (LGG) are located eloquently rendering surgical resection challenging. Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p<0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p < 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG>0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. There is a relevant improvement of neurological symptoms in the first year after surgery, especially for patients with slight aphasia.
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title_short	Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry
url	https://doi.org/10.3389/fonc.2022.845992 https://doaj.org/article/5c0492d198504cf0b65a41a66cdd902e https://www.frontiersin.org/articles/10.3389/fonc.2022.845992/full https://doaj.org/toc/2234-943X
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Aim of our study was to assess rate of permanent deficits and its predisposing risk factors. We retrieved 83 patients harboring an eloquently located LGGs from the prospective LoG-Glio Database. Patients without surgery or incomplete postoperative data were excluded. Sign rank test, explorative correlations by Spearman ρ and multivariable regression for new postoperative deficits were calculated. Eloquent region involved predominantly motor (45%) and language (40%). At first follow up after 3 months permanent neuro-logical deficits (NDs) were noted in 39%. Mild deficits remained in 29% and severe deficits in 10%. Complete tumor removal (CTR) was successfully in 62% of intended cases. Postoperative and 3-month follow up National Institute of Health Stroke Score (NIHSS) showed significantly lower values than preoperatively (p&lt;0.001). 38% cases showed a decreased NIHSS at 3-month, while occurrence was only 14% at 9-12-month follow up. 6/7 patients with mild aphasia recovered after 9-12 months, while motor deficits present at 3-month follow up were persistent in majority of patients. Eastern oncology group functional status (ECOG) significantly decreased by surgery (p &lt; 0.001) in 31% of cases. Between 3-month and 9-12-months follow up no significant improvement was seen. In the multivariable model CTR (p=0.019, OR 31.9), and ECOG&gt;0 (p=0.021, OR 8.5) were independent predictors for permanent postoperative deficit according to NIHSS at 3-month according to multivariable regression model. Patients harboring eloquently located LGG are highly vulnerable for permanent deficits. Almost one third of patients have a permanent reduction of their functional status based on ECOG. Risk of an extended resection has to be balanced with the respective oncological benefit. Especially, patients with impaired pre-operative status are at risk for new permanent deficits. 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Eloquent Lower Grade Gliomas, a Highly Vulnerable Cohort: Assessment of Patients’ Functional Outcome After Surgery Based on the LoG-Glio Registry

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