Surgery of high grade gliomas - pros in favor of maximal cytoreductive surgery

Background: Malignant glioma is themost common primary brain tumour inadults. More and more studies are focusedon the role of surgery in prolonged medianof survival and survival at two years. Thepurpose of this study is to add somearguments in favour of radical surgery inmalignant glioma.Material and Methods: The study is based433 cases of high grade cerebral gliomaoperated between 01.01.2000-31.12.2009 atthe Department of Neurosurgery, ClujCounty Emergency Hospital. We analyzedage, gender, type and duration ofsymptoms, type of surgery, pathologicaldiagnosis and the correlation of thesefactors with overall survival. Data for longterm follow up were available for 266patients.Results: The results shows, according totheir histological features, the fallowingdispersions: astrocitomas grade III (28%),glioblastoma multiforme (64%), high gradeoligodendrogliomas (5%) and high gradeependimomas (3%). The global survivalrate was 47 % at 12 months, 26,3% at 18months and 16,7% at 24 months. The ageand type of surgery are prognostic factorsthat significantly influenced the survival at12, 18 and 24 months (9,3 months age <65years versus 7,1 months age >65 years; 9,2months GTR versus 6,4 months STR-at 12months monitoring; 11,7 months age <65versus 7,7 months age >65; 11,5 monthsGTR versus 7,1 months STR-at 18 monthsmonitoring; 12,8 months age <65 versus 8months age >65; 12,6 months GTR versus7,5 months STR –at 24 monthsmonitoring).Conclusions: Our study shows that longterm postoperative outcome after radicalsurgical resection are better than the resultsof either partial resection or simple biopsy;in terms of duration of survival (thedifference of mean survival at 12, 18 and 24months monitoring was 2,8 months, 4,4months and 5,1 months respectively infavour of patients with gross total removal) .