Surgery for IDH1/2 wild-type glioma invading the corpus callosum

Pamela Franco, Daniel Delev, Debora Cipriani, Nicolas Neidert, Elias Kellner, Waseem Masalha, Bianca Mercas, Irina Mader, Peter Reinacher, Astrid Weyerbrock, Christian Fung, Jürgen Beck (+2 others)
2021 Acta neurochirurgica 163(4)  
Glioblastoma of the corpus callosum (ccGBM) are rare tumors, with a dismal prognosis marked by a rapid clinical deterioration. For a long time, surgical treatment was not considered beneficial for most patients with such tumors. Recent studies claimed an improved survival for patients undergoing extensive resection, albeit without integration of the molecular profile of the lesions. The purpose of this study was to investigate the effect of biopsy and surgical resection on oncological and
more » ... onal outcomes in patients with IDH wild-type ccGBM. Methods We performed a retrospective analysis of our institution's database of patients having been treated for high-grade glioma between 2005 and 2017. Inclusion criteria were defined as follows: patients older than 18 years, histopathological, and molecularly defined IDH wild-type glioma, major tumor mass (at least 2/3) invading the corpus callosum in the sagittal plane with a uni-or bilateral infiltration of the adjacent lobules. Surgical therapy (resection vs. biopsy), extent of resection according to the remaining tumor volume and adjuvant treatment as well as overall survival and functional outcome using the Karnofsky Performance Score (KPS) were analyzed. Results Fifty-five patients were included in the study, from which the mean age was 64 years and men (n = 34, 61.8%) were more often affected than women (n = 21, 38.2%). Thirty (54.5%) patients were treated with stereotactic biopsy alone, while 25 patients received tumor resection resulting in 14.5% (n = 8) gross-total resections and 30.9% (n = 17) partial resections. The 2-year survival rate after resection was 30% compared to 7% after biopsy (p = 0.047). The major benefit was achieved in the group with gross-total resection, while partial resection failed to improve survival. Neurological outcome measured by KPS did not differ between both groups either pre-or postoperatively. Conclusions Our study suggests that in patients with corpus callosum glioblastoma, gross-total resection prolongs survival without negatively impacting neurological outcome as compared to biopsy. This article is part of the Topical Collection on Tumor -Glioma Previous presentation Portions of this study were presented in oral presentation form at the 68th Annual Meeting of the German Society of Neurosurgery (DGNC) in Magdeburg on May 15, 2017.
doi:10.18154/rwth-conv-244069 fatcat:pjhswyxp2bhkjgcfcvde6nscpy