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Neurosurgical patterns of care for diffuse low-grade gliomas in Sweden between 2005 and 2015

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Variations in the management of diffuse low-grade gliomas-A Scandinavian multicenter study

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  1. Proposal of a new grading system for meningioma resection: the Copenhagen Protocol

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  2. Variations in the management of diffuse low-grade gliomas-A Scandinavian multicenter study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Louise Carstam
  • Anja Smits
  • Peter Milos
  • Alba Corell
  • Roger Henriksson
  • Jiri Bartek
  • Asgeir Store Jakola
Vis graf over relationer

Background: In the last decade, increasing evidence has evolved for early and maximal safe resection of diffuse low-grade gliomas (LGGs) regarding survival. However, changes in clinical practice are known to occur slowly and we do not know if the scientific evidence has yet resulted in changes in neurosurgical patterns of care.

Methods: The Swedish Brain Tumor Registry was used to identify all patients with a first-time histopathological diagnosis of LGG between 2005 and 2015. For analysis of surgical treatment patterns, we subdivided assessed time periods into 2005-2008, 2009-2012, and 2013-2015. Population-based data on patient and disease characteristics, surgical management, and outcomes were extracted.

Results: A total of 548 patients with diffuse World Health Organization grade II gliomas were identified: 142 diagnosed during 2005-2008, 244 during 2009-2012, and 162 during 2013-2015. Resection as opposed to biopsy was performed in 64.3% during 2005-2008, 74.2% during 2009-2012, and 74.1% during 2013-2015 (P = .08). There was no difference among the 3 periods regarding overall survival (P = .11). However, post hoc analysis of data from the 4 (out of 6) centers that covered all 3 time periods demonstrated a resection rate of 64.3% during 2005-2008, 77.4% during 2009-2012, and 75.4% during 2013-2015 (P = .02) and longer survival of patients diagnosed 2009 and onward (P = .04).

Conclusion: In this nationwide, population-based study we observed a shift over time in favor of LGG resection. Further, a positive correlation between the more active surgical strategy and longer survival is shown, although no causality can be claimed because of possible confounding factors.

OriginalsprogEngelsk
TidsskriftNeuro-Oncology Practice
Vol/bind6
Udgave nummer2
Sider (fra-til)124-133
Antal sider10
ISSN2054-2577
DOI
StatusUdgivet - mar. 2019

ID: 58587084