Next Article in Journal
Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys
Previous Article in Journal
Carotid Phase-Contrast Magnetic Resonance before Treatment: 4D-Flow versus Standard 2D Imaging
Article

Is It Worth Considering Multicentric High-Grade Glioma a Surgical Disease? Analysis of Our Clinical Experience and Literature Review

1
Unit of Neurosurgery, Department of Neurosciences, Hospital A. Manzoni, 23900 Lecco, Italy
2
Unit of Neurosurgery, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
3
Unit of Neurosurgery, Hospital S. M. Goretti, 04100 Latina, Italy
4
Unit of Pathology, Department of Oncology, Hospital A. Manzoni, 23900 Lecco, Italy
5
Orthopedic Biotechnology Lab, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy
6
Unit of Neurology, Department of Neurosciences, Hospital A. Manzoni, 23900 Lecco, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Emilio Quaia
Tomography 2021, 7(4), 523-532; https://doi.org/10.3390/tomography7040045
Received: 9 August 2021 / Revised: 8 September 2021 / Accepted: 29 September 2021 / Published: 5 October 2021
(This article belongs to the Special Issue Clinical and Molecular Analytic in Neuro-Oncology)
Introduction. The simultaneous presence of multiple foci of high-grade glioma is a rare condition with a poor prognosis. By definition, if an anatomical connection through white matter bundles cannot be hypothesized, multiple lesions are defined as multicentric glioma (MC); on the other hand, when this connection exists, it is better defined as multifocal glioma (MF). Whether surgery can be advantageous for these patients has not been established yet. The aim of our study was to critically review our experience and to compare it to the existing literature. Materials and Methods. Retrospective analysis of patients operated on for MC HGG in two Italian institutions was performed. Distinction between MC and MF was achieved through revision of MR FLAIR images. Clinical and radiological preoperative and postoperative data were analyzed through chart revision and phone interviews. The same data were extracted from literature review. Univariate and multivariate analyses were conducted for the literature review only, and the null hypothesis was rejected for a p-value ≥ 0.05. Results. Sixteen patients met the inclusion criteria; male predominance and an average age of 66.5 years were detected. Sensory/motor deficit was the main onset symptom both in clinical study and literature review. A tendency to operate on the largest symptomatic lesion was reported and GTR was reached in the majority of cases. GBM was the histological diagnosis in most part of the patients. OS was 8.7 months in our series compared to 7.5 months from the literature review. Age ≤ 70 years, a postoperative KPS ≥ 70, a GTR/STR, a second surgery and adjuvant treatment were shown to be significantly associated with a better prognosis. Pathological examination revealed that MC HGG did not originate by LGG. Conclusions. MC gliomas are rare conditions with high malignancy and a poor prognosis. A maximal safe resection should be attempted whenever possible, especially in younger patients with life-threatening large mass. View Full-Text
Keywords: glioblastoma; MRI; multifocal; brain; tumor glioblastoma; MRI; multifocal; brain; tumor
Show Figures

Figure 1

MDPI and ACS Style

Guerrini, F.; Mazzeo, L.A.; Rossi, G.; Verlotta, M.; Del Maestro, M.; Rampini, A.D.; Pesce, A.; Viganò, M.; Luzzi, S.; Galzio, R.J.; Salmaggi, A.; Spena, G. Is It Worth Considering Multicentric High-Grade Glioma a Surgical Disease? Analysis of Our Clinical Experience and Literature Review. Tomography 2021, 7, 523-532. https://doi.org/10.3390/tomography7040045

AMA Style

Guerrini F, Mazzeo LA, Rossi G, Verlotta M, Del Maestro M, Rampini AD, Pesce A, Viganò M, Luzzi S, Galzio RJ, Salmaggi A, Spena G. Is It Worth Considering Multicentric High-Grade Glioma a Surgical Disease? Analysis of Our Clinical Experience and Literature Review. Tomography. 2021; 7(4):523-532. https://doi.org/10.3390/tomography7040045

Chicago/Turabian Style

Guerrini, Francesco, Lucio A. Mazzeo, Giorgio Rossi, Mariarosaria Verlotta, Mattia Del Maestro, Angela D. Rampini, Alessandro Pesce, Marco Viganò, Sabino Luzzi, Renato J. Galzio, Andrea Salmaggi, and Giannantonio Spena. 2021. "Is It Worth Considering Multicentric High-Grade Glioma a Surgical Disease? Analysis of Our Clinical Experience and Literature Review" Tomography 7, no. 4: 523-532. https://doi.org/10.3390/tomography7040045

Find Other Styles

Article Access Map by Country/Region

1
Back to TopTop