Proposed novel classification of circumscribed Lower-Grade Gliomas (cLGG) vs. infiltrating Lower-Grade Gliomas (iLGG): Correlations of radiological features and clinical outcomes

Authors

Ahsan Ali Khan, Aga Khan UniversityFollow
Muhammad Usman Khalid, Aga Khan UniversityFollow
Mohammad Hamza Bajwa, Aga Khan UniversityFollow
Faiza Urooj, Aga Khan UniversityFollow
kiran Aftab, Aga Khan UniversityFollow
Ather Enam, Aga Khan UniversityFollow
Fahad Zahid, Aga Khan UniversityFollow
Muhammad Waqas Saeed Baqai, Aga Khan University
Izza Tahir, Aga Khan University
Meher Angez, Aga Khan UniversityFollow
Shahabuddin Ansari, Institute of Engineering Sciences and Technology,Pakistan

Document Type

Article

Department

Neurosurgery

Abstract

Purpose: We hypothesize that lower grade gliomas (LGG) can be identified and classified into two distinct subtypes: radiologically circumscribed Lower-Grade Gliomas (cLGG) and infiltrating Lower-Grade Gliomas (iLGG) based on radiological parameters and that these two different subtypes behave differently in terms of clinical outcomes.
Methods: We conducted a retrospective cohort study on surgical patients diagnosed with lower grade glioma over five years. Patient records and MRIs were reviewed, and neurosurgeons classified tumors into cLGG and iLGG groups.
Results: From the 165 patients in our cohort, 30 (18.2%) patients were classified as cLGG and 135 (81.8%) patients were classified as iLGG Mean age in cLGG was 31.4 years while mean age in iLGG was 37.9 years (p = 0.004). There was significant difference in mean blood loss between cLGG and iLGG groups (270 and 411 ml respectively, p = 0.020). cLGG had a significantly higher proportion of grade II tumors (p < 0.001). The overall mean survival time for the iLGG group was 14.96 ± 1.23 months, and 18.77 ± 2.72 months for the cLGG group. In univariate cox regression, the survival difference between LGG groups was not significant (HR = 0.888, p = 0.581), however on multivariate regression cLGG showed a significant (aHZ = 0.443, p = 0.015) positive correlation with survival. Intense contrast enhancement (HZ = 41.468, p = 0.018), blood loss (HZ = 1.002, p = 0.049), and moderately high Ki-67 (HZ = 4.589, p = 0.032) were also significant on univariate analyses.Conclusion: cLGG and iLGG are radiologically distinct groups with separate prognoses, surgical experience, and associations.

Comments

Issue and pagination are not provided by author/publisher

Publication (Name of Journal)

World Neurosurgery

DOI

10.1016/j.wnsx.2024.100356

Recommended Citation

Khan, A. A., Khalid, M. U., Bajwa, M. H., Urooj, F., Aftab, k., Enam, A., Zahid, F., Baqai, M. S., Tahir, I., Angez, M., Ansari, S. (2024). Proposed novel classification of circumscribed Lower-Grade Gliomas (cLGG) vs. infiltrating Lower-Grade Gliomas (iLGG): Correlations of radiological features and clinical outcomes. World Neurosurgery, 23.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_neurosurg/377