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Resection extent and BRAF V600E mutation status determine postoperative tumor growth velocity in pediatric low-grade glioma: results from a single-center cohort analysis
PURPOSE: Despite excellent long-term overall survival rates, pediatric low-grade gliomas (pLGG) show high variety of clinical behavior regarding progress or senescence post incomplete resection (IR). This study retrospectively analyzes tumor growth velocity (TGV) of pLGG before surgery and after IR...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758245/ https://www.ncbi.nlm.nih.gov/pubmed/36319795 http://dx.doi.org/10.1007/s11060-022-04176-4 |
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author | Gorodezki, David Zipfel, Julian Queudeville, Manon Sosa, Jordana Holzer, Ursula Kern, Jan Bevot, Andrea Schittenhelm, Jens Nägele, Thomas Ebinger, Martin Schuhmann, Martin U. |
author_facet | Gorodezki, David Zipfel, Julian Queudeville, Manon Sosa, Jordana Holzer, Ursula Kern, Jan Bevot, Andrea Schittenhelm, Jens Nägele, Thomas Ebinger, Martin Schuhmann, Martin U. |
author_sort | Gorodezki, David |
collection | PubMed |
description | PURPOSE: Despite excellent long-term overall survival rates, pediatric low-grade gliomas (pLGG) show high variety of clinical behavior regarding progress or senescence post incomplete resection (IR). This study retrospectively analyzes tumor growth velocity (TGV) of pLGG before surgery and after IR to investigate the impact of surgical extent, tumor location and molecular BRAF status on postoperative residual tumor growth behavior. METHODS: Of a total of 172 patients with pLGG receiving surgical treatment, 107 underwent IR (66%). Fifty-three vs 94 patients could be included in the pre- and post-operative cohort, respectively, and were observed over a mean follow-up time of 40.2 vs 60.1 months. Sequential three-dimensional MRI-based tumor volumetry of a total of 407 MRI scans was performed to calculate pre- and postoperative TGV. RESULTS: Mean preoperative TGV of 0.264 cm(3)/month showed significant deceleration of tumor growth to 0.085 cm(3)/month, 0.024 cm(3)/month and −0.016 cm(3)/month after 1st, 2nd, and 3rd IR, respectively (p < 0.001). Results remained significant after excluding patients undergoing (neo)adjuvant treatment. Resection extent showed correlation with postoperative reduction of TGV (R = 0.97, p < 0.001). ROC analysis identified a residual cut-off tumor volume > 2.03 cm(3) associated with a higher risk of progress post IR (sensitivity 78,6%, specificity 76.3%, AUC 0.88). Postoperative TGV of BRAF V600E-mutant LGG was significantly higher than of BRAF wild-type LGG (0.123 cm(3)/month vs. 0.016 cm(3)/month, p = 0.047). CONCLUSION: This data suggests that extensive surgical resection may impact pediatric LGG growth kinetics post incomplete resection by inducing a significant deceleration of tumor growth. BRAF-V600E mutation may be a risk factor for higher postoperative TGV. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11060-022-04176-4. |
format | Online Article Text |
id | pubmed-9758245 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-97582452022-12-18 Resection extent and BRAF V600E mutation status determine postoperative tumor growth velocity in pediatric low-grade glioma: results from a single-center cohort analysis Gorodezki, David Zipfel, Julian Queudeville, Manon Sosa, Jordana Holzer, Ursula Kern, Jan Bevot, Andrea Schittenhelm, Jens Nägele, Thomas Ebinger, Martin Schuhmann, Martin U. J Neurooncol Case Study PURPOSE: Despite excellent long-term overall survival rates, pediatric low-grade gliomas (pLGG) show high variety of clinical behavior regarding progress or senescence post incomplete resection (IR). This study retrospectively analyzes tumor growth velocity (TGV) of pLGG before surgery and after IR to investigate the impact of surgical extent, tumor location and molecular BRAF status on postoperative residual tumor growth behavior. METHODS: Of a total of 172 patients with pLGG receiving surgical treatment, 107 underwent IR (66%). Fifty-three vs 94 patients could be included in the pre- and post-operative cohort, respectively, and were observed over a mean follow-up time of 40.2 vs 60.1 months. Sequential three-dimensional MRI-based tumor volumetry of a total of 407 MRI scans was performed to calculate pre- and postoperative TGV. RESULTS: Mean preoperative TGV of 0.264 cm(3)/month showed significant deceleration of tumor growth to 0.085 cm(3)/month, 0.024 cm(3)/month and −0.016 cm(3)/month after 1st, 2nd, and 3rd IR, respectively (p < 0.001). Results remained significant after excluding patients undergoing (neo)adjuvant treatment. Resection extent showed correlation with postoperative reduction of TGV (R = 0.97, p < 0.001). ROC analysis identified a residual cut-off tumor volume > 2.03 cm(3) associated with a higher risk of progress post IR (sensitivity 78,6%, specificity 76.3%, AUC 0.88). Postoperative TGV of BRAF V600E-mutant LGG was significantly higher than of BRAF wild-type LGG (0.123 cm(3)/month vs. 0.016 cm(3)/month, p = 0.047). CONCLUSION: This data suggests that extensive surgical resection may impact pediatric LGG growth kinetics post incomplete resection by inducing a significant deceleration of tumor growth. BRAF-V600E mutation may be a risk factor for higher postoperative TGV. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11060-022-04176-4. Springer US 2022-11-01 2022 /pmc/articles/PMC9758245/ /pubmed/36319795 http://dx.doi.org/10.1007/s11060-022-04176-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Case Study Gorodezki, David Zipfel, Julian Queudeville, Manon Sosa, Jordana Holzer, Ursula Kern, Jan Bevot, Andrea Schittenhelm, Jens Nägele, Thomas Ebinger, Martin Schuhmann, Martin U. Resection extent and BRAF V600E mutation status determine postoperative tumor growth velocity in pediatric low-grade glioma: results from a single-center cohort analysis |
title | Resection extent and BRAF V600E mutation status determine postoperative tumor growth velocity in pediatric low-grade glioma: results from a single-center cohort analysis |
title_full | Resection extent and BRAF V600E mutation status determine postoperative tumor growth velocity in pediatric low-grade glioma: results from a single-center cohort analysis |
title_fullStr | Resection extent and BRAF V600E mutation status determine postoperative tumor growth velocity in pediatric low-grade glioma: results from a single-center cohort analysis |
title_full_unstemmed | Resection extent and BRAF V600E mutation status determine postoperative tumor growth velocity in pediatric low-grade glioma: results from a single-center cohort analysis |
title_short | Resection extent and BRAF V600E mutation status determine postoperative tumor growth velocity in pediatric low-grade glioma: results from a single-center cohort analysis |
title_sort | resection extent and braf v600e mutation status determine postoperative tumor growth velocity in pediatric low-grade glioma: results from a single-center cohort analysis |
topic | Case Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758245/ https://www.ncbi.nlm.nih.gov/pubmed/36319795 http://dx.doi.org/10.1007/s11060-022-04176-4 |
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