Survival rates in patients with low‐grade glioma after intraoperative magnetic resonance image guidance

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Abstract
BACKGROUND: No age‐adjusted or histologic‐adjusted assessments of the association between extent of resection and risk of either recurrence or death exist for neurosurgical patients who undergo resection of low‐grade glioma using intraoperative magnetic resonance image (MRI) guidance.METHODS: The current data included 156 patients who underwent surgical resection of a unifocal, supratentorial, low‐grade glioma in the MRI suite at Brigham and Women's Hospital between January 1, 1997, and January 31, 2003. Estimates of disease‐free and overall survival probabilities were calculated using Kaplan–Meier methodology. The association between extent of resection and these probabilities was measured using a Cox proportional hazards model. Observed death rates were compared with the expected death rate using age‐specific and histologic‐specific survival rates obtained from the Surveillance, Epidemiology, and End Results Registry.RESULTS: Patients who underwent subtotal resection were at 1.4 times the risk of disease recurrence (95% confidence interval [95% CI], 0.7–3.1) and at 4.9 times the risk of death (95% CI, 0.61–40.0) relative to patients who underwent gross total resection. The 1‐year, 2‐year, and 5‐year age‐adjusted and histologic‐adjusted death rates for patients who underwent surgical resection using intraoperative MRI guidance were 1.9% (95% CI, 0.3–4.2%), 3.6% (95% CI, 0.4–6.7%), and 17.6% (95% CI, 5.9–29.3%), respectively: significantly lower than the rates reported using national data bases.CONCLUSIONS: The data from the current study suggested a possible association between surgical resection and survival for neurosurgical patients who underwent surgery for low‐grade glioma under intraoperative MRI guidance. Further study within the context of a large, prospective, population‐based project will be needed to confirm these findings. Cancer 2005. © 2005 American Cancer Society.