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Survival
rates in patients with low-grade glioma after intraoperative magnetic
resonance image guidance
Claus
EB, Horlacher A, Hsu L, Schwartz RB, Dello-Iacono D, Talos F, Jolesz
FA, Black PM
Department
of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts,
USA. elizabeth.claus@yale.edu
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.
PMID: 15690327 [PubMed - in process]
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