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Open AccessArticle

Cognitive Functions in Repeated Glioma Surgery

1
Department of Neurosurgery, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, 33100 Udine, Italy
2
Scientific Institute, IRCCS E. Medea, San Vito al Tagliamento, 33078 Pordenone, Italy
3
Department of Medical and Biological Sciences, Section of Statistics, University of Udine, 33100 Udine, Italy
*
Authors to whom correspondence should be addressed.
Cancers 2020, 12(5), 1077; https://doi.org/10.3390/cancers12051077
Received: 13 April 2020 / Accepted: 21 April 2020 / Published: 26 April 2020
(This article belongs to the Special Issue Recurrent Glioblastoma)
Low-grade gliomas (LGG) are slow-growing brain tumors infiltrating the central nervous system which tend to recur, often with malignant degeneration after primary treatment. Re-operations are not always recommended due to an assumed higher risk of neurological and cognitive deficits. However, this assumption is relatively ungrounded due to a lack of extensive neuropsychological testing. We retrospectively examined a series of 40 patients with recurrent glioma in eloquent areas of the left hemisphere, who all completed comprehensive pre- (T3) and post-surgical (T4) neuropsychological assessments after a second surgery (4-month follow up). The lesions were most frequent in the left insular cortex and the inferior frontal gyrus. Among this series, in 17 patients the cognitive outcomes were compared before the first surgery (T1), 4 months after the first surgery (T2), and at T3 and T4. There was no significant difference either in the number of patients scoring within the normal range between T3 and T4, or in their level of performance. Further addressing the T1–T4 evolution, there was no significant difference in the number of patients scoring within the normal range. As to their level of performance, the only significant change was in phonological fluency. This longitudinal follow-up study showed that repeated glioma surgery is possible without major damage to cognitive functions in the short-term period (4 months) after surgery. View Full-Text
Keywords: awake surgery; neurocognition; neuropsychological assessment; diffuse low surgery awake surgery; neurocognition; neuropsychological assessment; diffuse low surgery
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Capo, G.; Skrap, M.; Guarracino, I.; Isola, M.; Battistella, C.; Ius, T.; Tomasino, B. Cognitive Functions in Repeated Glioma Surgery. Cancers 2020, 12, 1077.

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