Management of patients with low-grade gliomas - a survey among German neurosurgical departments

Cent Eur Neurosurg. 2011 Nov;72(4):186-91. doi: 10.1055/s-0031-1275351. Epub 2011 May 13.

Abstract

Background and aims of the study: The diagnosis and treatment of low-grade gliomas (LGG) are multimodal. Today, there is no defined standard in diagnosis and treatment. Controversies are, in general, about a "wait-and-see" strategy, diagnostic workup, surgical intervention, postoperative imaging, adjuvant treatment, and follow-up. The aim of this study is to gain an overview about management strategies of high-volume German neurosurgical departments treating these patients.

Material and methods: A questionnaire including diagnostic, preoperative, perioperative, and postoperative parameters and 5 cases with magnetic resonance imaging data with questions to various treatment options in these patients was sent to all 34 German neurosurgical departments at university hospitals.

Results: In total, 24 questionnaires were returned and analysed. Centres were divided into those who generally practice a "wait-and-see" strategy vs. those who do not or only in highly selected cases. Statistical analyses were performed with Fisher test and Chi (2)-test. Interestingly, 50% of all centres routinely follow a "wait-and-see" strategy.

Conclusion: Although the management of patients with LGG is complex and a simple questionnaire will not be able to define a standard in diagnosis and treatment, this study offers an overview on strategies at high-volume academic centres dealing with these patients. There is consensus to resect superficially located lobar and circumscribed low-grade lesions. However, the differences between centres become apparent with increasing complexity of the lesions.

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / genetics
  • Brain Neoplasms / surgery*
  • Chemoradiotherapy, Adjuvant
  • Combined Modality Therapy
  • DNA / genetics
  • Female
  • Germany
  • Glioma / diagnosis
  • Glioma / genetics
  • Glioma / surgery*
  • Goals
  • Health Care Surveys
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Monitoring, Intraoperative
  • Neoplasm Recurrence, Local
  • Neuronavigation
  • Neurosurgical Procedures / statistics & numerical data
  • Positron-Emission Tomography
  • Postoperative Period
  • Surgery, Computer-Assisted
  • Surveys and Questionnaires
  • Watchful Waiting

Substances

  • DNA