Outcome predictors in a series of 40 patients after surgery for low-grade gliomas

Objective: Low grade gliomas (LGGs) account for 15 % of primary brain tumors. The paper has the aim toidentifying prognostic factors affecting overall survival (OS) and progression-free survival (PFS), and to evaluatethe outcome of patients.Methods: A total of 40 patients undergoing surgery for cerebral LGG (WHO grades I and II) at Our Institute wereenrolled in the retrospective study. Inclusion criteria were: histological diagnosis of LGG, availability of completeclinical-instrumental documentation and follow-up data. For each patient, the following were analyzed: theclinical parameters in the preoperative and postoperative phases, the histological variant of the tumor, the extentof surgical resection (EOR) and any use of intraoperative methods, the Mib-1/Ki-67 proliferation index, theadministration of adjuvant chemotherapy and/or radiotherapy and the occurrence of any complications.Results: The cohort included 14 males and 26 females. The independent predictors of OS at multivariate analysiswere: age, pre-operative KPS, Ki67/Mib-1, EOR and adjuvant chemotherapy. With regard to PFS, statisticalsignificance on multivariate analysis was observed for pre-operative KPS, Ki67/Mib-1, EOR, post-operativetumor volume and radiotherapy. An EOR < 80 % was confirmed as negative prognostic factor for both OSand PFS. Lastly, the pre-operative tumor volume and the use of Intra-operative Electrophysiological Monitoringwere significantly associated with EOR.Conclusion: In this study, according to the literature, several prognostic factors determining the outcome of LGGpatients, both in terms of OS and PFS, were confirmed. Knowing the impact of these parameters in terms ofprognosis would guide the choice of treatment, which will necessarily be multidisciplinary and tailored.