Low-grade glioma with foci of early transformation does not necessarily require adjuvant therapy following radical surgical resection.

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Low-grade glioma with foci of early transformation does not necessarily require adjuvant therapy following radical surgical resection.

World Neurosurg. 2017 Nov 09;:

Authors: Al-Tamimi YZ, Palin MS, Patankar T, MacMullen-Price J, O'Hara DJ, Loughrey C, Chakrabarty A, Ismail A, Roberts P, Duffau H, Goodden JR, Chumas PD

Abstract
BACKGROUND: Low-grade glioma (LGG) is a slow-growing tumour often found in young adults with minimal or no symptoms. As opposed to true 'low-grade' lesions like dysembryoplastic neuroepithelial tumours (DNETs), they are associated with continuous growth and inevitable malignant transformation.
METHOD: Case series of patients who have had en-bloc resection of low-grade glioma with foci of anaplasia found within embedded within the tumour specimen and not at margins. Patients offered and agreed to a conservative approach avoiding adjuvant therapy.
RESULTS: In the current case series, we describe a small subset of LGG that have demonstrated foci of high-grade glioma but have exhibited behaviour and growth tendencies similar to LGG following radical surgical resection. All patients have to-date not exhibited recurrent disease requiring adjuvant therapy.
CONCLUSION: This case series supports the use of early aggressive surgical treatment of grade II gliomas that are in fact pre-malignant. It acts as proof of concept that following radical resection, the presence of small foci of transformation embedded within grade II tumour may be treated with close radiological surveillance rather than immediate adjuvant therapy.

PMID: 29129767 [PubMed - as supplied by publisher]

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