Journal of neuro-oncology · 2026
Surgical characteristics and postoperative outcomes in a retrospective cohort study of patients with molecularly defined oligodendroglioma.
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Kalluri Anita L, Carmichael Austin, Rakovec Maureen, Jiang Kelly, Parker Megan, Weber-Levine Carly, Raj Divyaansh, Materi Josh, Schreck Karisa C, Aldecoa Iban, Redmond Kristin J, Holdhoff Matthias, Weingart Jon, Brem Henry, Ye Xiaobu, Bettegowda Chetan, Sánchez Josep J González, Rincon-Torroella Jordina
Аннотация
PURPOSE: Oligodendroglioma, an adult diffuse glioma now defined by molecular criteria, is typically managed first surgically. This retrospective cohort study correlates surgical characteristics with postoperative outcomes in purely molecularly defined oligodendroglioma.
METHODS: Adults with surgically managed 1p/19q co-deleted, IDH-mutated oligodendroglioma were identified. Medical records were reviewed for demographics, radiologic features, treatments, and postoperative outcomes.
RESULTS: Two hundred seventy-seven patients (207 grade 2, 70 grade 3) were included; most presented with seizures (173/267, 64.8%), non-contrast enhancing lesions (128/213, 60.1%), and frontal lobe tumors (170/267, 63.7%). Subtotal resection (STR, 115/249, 46.2%) and gross total resection (GTR, 97/249, 39.0%) were more common than biopsy (37/249, 14.9%). Awake procedures were performed in 25/173 (14.5%) cases. New permanent neurological deficits occurred in 24/254 (9.4%) patients. Median (IQR) follow-up was 57 (20-107) months. Individuals undergoing GTR or STR had longer median progression-free survival (PFS) than patients who underwent biopsy (76 versus 44 months, p = 0.007). In multivariable analysis, GTR, but not STR, was an independent predictor of improved PFS compared to biopsy after adjusting for demographics, grade, and adjuvant treatment (p = 0.026). The PFS benefit of GTR over biopsy was maintained in subgroup analyses of grade 2 tumors (p = 0.032) but not grade 3 tumors (p = 0.549).
CONCLUSIONS: In this retrospective cohort of individuals with molecularly defined oligodendrogliomas, GTR was associated with prolonged PFS compared to biopsy without an observed increase in postoperative neurological deficits.
METHODS: Adults with surgically managed 1p/19q co-deleted, IDH-mutated oligodendroglioma were identified. Medical records were reviewed for demographics, radiologic features, treatments, and postoperative outcomes.
RESULTS: Two hundred seventy-seven patients (207 grade 2, 70 grade 3) were included; most presented with seizures (173/267, 64.8%), non-contrast enhancing lesions (128/213, 60.1%), and frontal lobe tumors (170/267, 63.7%). Subtotal resection (STR, 115/249, 46.2%) and gross total resection (GTR, 97/249, 39.0%) were more common than biopsy (37/249, 14.9%). Awake procedures were performed in 25/173 (14.5%) cases. New permanent neurological deficits occurred in 24/254 (9.4%) patients. Median (IQR) follow-up was 57 (20-107) months. Individuals undergoing GTR or STR had longer median progression-free survival (PFS) than patients who underwent biopsy (76 versus 44 months, p = 0.007). In multivariable analysis, GTR, but not STR, was an independent predictor of improved PFS compared to biopsy after adjusting for demographics, grade, and adjuvant treatment (p = 0.026). The PFS benefit of GTR over biopsy was maintained in subgroup analyses of grade 2 tumors (p = 0.032) but not grade 3 tumors (p = 0.549).
CONCLUSIONS: In this retrospective cohort of individuals with molecularly defined oligodendrogliomas, GTR was associated with prolonged PFS compared to biopsy without an observed increase in postoperative neurological deficits.