イセキ　ヒロシ   Iseki Hiroshi   伊関　洋    所属   医学研究科 医学研究科 (医学部医学科をご参照ください)    職種   特任顧問
論文種別	総説
言語種別	英語
査読の有無	査読あり
表題	Updated therapeutic strategy for adult low-grade glioma stratified by resection and tumor subtype.
掲載誌名	正式名：Neurologia medico-chirurgica 略　 称：Neurol Med Chir (Tokyo) ISSNコード：04708105/13498029
掲載区分	国外
巻・号・頁	53(7),pp.447-454
著者・共著者	NITTA Masayuki†, MURAGAKI Yoshihiro, MARUYAMA Takashi, ISEKI Hiroshi, IKUTA Soko, KONISHI Yoshiyuki, SAITO Taichi, TAMURA Manabu, CHERNOV Michael, WATANABE Atsushi, OKAMOTO Saori, MAEBAYASHI Katsuya, MITSUHASHI Norio, OKADA Yoshikazu
発行年月	2013/07
概要	The importance of surgical resection for patients with supratentorial low-grade glioma (LGG) remains controversial. This retrospective study of patients (n = 153) treated between 2000 to 2010 at a single institution assessed whether increasing the extent of resection (EOR) was associated with improved progression-free survival (PFS) and overall survival (OS). Histological subtypes of World Health Organization grade II tumors were as follows: diffuse astrocytoma in 49 patients (32.0%), oligoastrocytoma in 45 patients (29.4%), and oligodendroglioma in 59 patients (38.6%). Median pre- and postoperative tumor volumes and median EOR were 29.0 cm(3) (range 0.7-162 cm(3)) and 1.7 cm(3) (range 0-135.7 cm(3)) and 95%, respectively. Five- and 10-year OS for all LGG patients were 95.1% and 85.4%, respectively. Eight-year OS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 70.7%, 91.2%, and 98.3%, respectively. Five-year PFS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 42.6%, 71.3%, and 62.7%, respectively. Patients were divided into two groups by EOR >/=90% and <90%, and OS and PFS were analyzed. Both OS and PFS were significantly longer in patients with >/=90% EOR. Increased EOR resulted in better PFS for diffuse astrocytoma but not for oligodendroglioma. Multivariate analysis identified age and EOR as parameters significantly associated with OS. The only parameter associated with PFS was EOR. Based on these findings, we established updated therapeutic strategies for LGG. If surgery resulted in EOR <90%, patients with astrocytoma will require second-look surgery, whereas patients with oligodendroglioma or oligoastrocytoma, which are sensitive to chemotherapy, will be treated with chemotherapy.
DOI	10.2176/nmc.53.447
PMID	23883555