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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


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  • Bodil Karoline Ravn Munkvold
  • Ole Solheim
  • Jiri Bartek
  • Alba Corell
  • Eddie de Dios
  • Sasha Gulati
  • Eirik Helseth
  • Klas Holmgren
  • Margret Jensdottir
  • Mina Lundborg
  • Eduardo Erasmo Mendoza Mireles
  • Ruby Mahesparan
  • Øystein Vesterli Tveiten
  • Peter Milos
  • Henrietta Nittby Redebrandt
  • Lars Kjelsberg Pedersen
  • Jon Ramm-Pettersen
  • Rickard L Sjöberg
  • Björn Sjögren
  • Kristin Sjåvik
  • Anja Smits
  • Gregor Tomasevic
  • Tomás Gómez Vecchio
  • Einar O Vik-Mo
  • Maria Zetterling
  • Øyvind Salvesen
  • Asgeir S Jakola
Vis graf over relationer

Background: Early extensive surgery is a cornerstone in treatment of diffuse low-grade gliomas (DLGGs), and an additional survival benefit has been demonstrated from early radiochemotherapy in selected "high-risk" patients. Still, there are a number of controversies related to DLGG management. The objective of this multicenter population-based cohort study was to explore potential variations in diagnostic work-up and treatment between treating centers in 2 Scandinavian countries with similar public health care systems.

Methods: Patients screened for inclusion underwent primary surgery of a histopathologically verified diffuse WHO grade II glioma in the time period 2012 through 2017. Clinical and radiological data were collected from medical records and locally conducted research projects, whereupon differences between countries and inter-hospital variations were explored.

Results: A total of 642 patients were included (male:female ratio 1:4), and annual age-standardized incidence rates were 0.9 and 0.8 per 100 000 in Norway and Sweden, respectively. Considerable inter-hospital variations were observed in preoperative work-up, tumor diagnostics, surgical strategies, techniques for intraoperative guidance, as well as choice and timing of adjuvant therapy.

Conclusions: Despite geographical population-based case selection, similar health care organizations, and existing guidelines, there were considerable variations in DLGG management. While some can be attributed to differences in clinical implementation of current scientific knowledge, some of the observed inter-hospital variations reflect controversies related to diagnostics and treatment. Quantification of these disparities renders possible identification of treatment patterns associated with better or worse outcomes and may thus represent a step toward more uniform evidence-based care.

TidsskriftNeuro-Oncology Practice
Udgave nummer6
Sider (fra-til)706-717
Antal sider12
StatusUdgivet - dec. 2021

Bibliografisk note

© The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology.

ID: 70531985