Management of supratentorial recurrent low‑grade glioma: A multidisciplinary experience in 35 adult patients

Spitaels,Julien; Devriendt,Daniel; Sadeghi,Niloufar; Luce,Sylvie; De Witte,Olivier; Goldman,Serge; Mélot,Christian; Lefranc,Florence

doi:10.3892/ol.2017.6543

Management of supratentorial recurrent low‑grade glioma: A multidisciplinary experience in 35 adult patients

Authors:
- Julien Spitaels
- Daniel Devriendt
- Niloufar Sadeghi
- Sylvie Luce
- Olivier De Witte
- Serge Goldman
- Christian Mélot
- Florence Lefranc
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Affiliations: Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium, Department of Radiotherapy, Institut Jules Bordet, 1000 Brussels, Belgium, Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium, Department of Medical Oncology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium, Department of Nuclear Medicine, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium, Department of Emergency, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium
Published online on: July 8, 2017 https://doi.org/10.3892/ol.2017.6543
Pages: 2789-2795
Copyright: © Spitaels et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The management of recurrent diffuse low‑grade gliomas (LGGs) is controversial. In the present study, the multidisciplinary management of 35 patients with recurrent LGGs was retrospectively analyzed. Tumor progression or recurrence was defined by clinical, radiological and/or metabolic pejorative evolution. All patients were regularly followed up by a multidisciplinary neuro‑oncological group at Hôpital Erasme. Patients with histologically confirmed supratentorial LGGs (7 astrocytoma, 22 oligodendrogliomas and 6 oligoastrocytomas) who had undergone surgery between August 2004 and November 2010 were included. A total of 3 patients exhibited no tumor progression (median follow‑up (FU), 81 months; range, 68‑108 months). Tumor recurrence occurred in the 32 remaining patients [progression‑free survival (PFS), 26 months; range, 2‑104 months]. In addition, 25/29 (86%) patients who received surgery alone underwent reoperation at the time of tumor recurrence, and high‑grade transformation occurred in 6 of these patients (24%). Furthermore, 4/29 (14%) patients were treated with adjuvant therapy alone (3 chemotherapy and 1 radiotherapy). In the 19 patients with no high‑grade transformation at reintervention, 3 received adjuvant therapy and 16 were regularly followed up through multimodal imaging. The PFS time of the patients who underwent reoperation with close FU (n=16) and for the patients receiving adjuvant therapy with or without surgery (n=7) at first recurrence was 10 and 24 months (P=0.005), respectively. However, no significant difference was observed for overall survival (P=0.403). At the time of this study, 22 of the 35 patients included were alive following a median FU time of 109 months (range, 55‑136). The results of the present study could change the multidisciplinary approach used into a more aggressive approach with adjuvant therapy, with or without surgery, for the treatment of a select subpopulation of patients with LGGs at the first instance of tumor recurrence.

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