EPID-10GROSS TOTAL RESECTION IS NOT ASSOCIATED WITH IMPROVED OVERALL SURVIVAL RELATIVE TO SUBTOTAL RESECTION IN PATIENTS WITH OLIGODENDROGLIOMAS, ANAPLASTIC OLIGODENDROGLIOMAS, AND OLIGOASTROCYTOMAS

Abstract

INTRODUCTION: Surgical decisions guiding the resection of primary brain tumors need to be grounded on evidence of benefit. Using the Surveillance, Epidemiology and End Results (SEER) database, we previously demonstrated robust survival difference between patients who underwent gross total resection (GTR) and subtotal resection (STR). Here we provide an analysis of the patient population afflicted with oligodendrogliomas, anaplastic oligodendrogliomas, and oligoastrocytomas. METHODS: In the SEER database (1999-2010), we identified 2,378 low-grade oligodendrogliomas, 1,028 anaplastic oligodendrogliomas (WHO grade III), and 1,505 oligoastrocytomas (all grades). Kaplan-Meier and multivariate Cox regression were used to assess the pattern of surgical practice and overall survival. RESULTS: In contrast to findings reported for anaplastic astrocytoma and glioblastomas, there is little overall survival benefit between low-grade oligodendrogliomas, anaplastic oligodendrogliomas, and oligoastrocytomas patients who underwent GTR relative to STR. The hazard ratio of dying from low-grade oligodendroglioma in patients who underwent GTR relative to STR was 0.948, (CI: 0.709-1.269; p = 0.720). The hazard ratio of dying from anaplastic oligodendroglioma in patients who underwent GTR relative to STR was 0.866, (CI: 0.654-1.148; p = 0.317). The hazard ratio of dying from low-grade oligoastrocytoma in patients who underwent GTR relative to STR was 1.113, (CI: 0.862-1.437; p = 0.413). CONCLUSION: In contrast to patients with anaplastic astrocytoma and glioblastoma, we observed no significant survival benefit of GTR relative to STR in patients afflicted with glial tumors with an oligodendro-component. Surgical consideration should be undertaken in this context.