Skip to main content
SpringerLink
Log in

Management of Low-Grade Gliomas: A Surgical Perspective

  • Chapter
Combined Modality Therapy of Central Nervous System Tumors

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

  • 177 Accesses

Abstract

Low-grade gliomas pose a daunting challenge to all clinicians involved in their management.Far from a single clinicopathological entity, this group of tumors is characterized by numerous histologic subtypes each possessing their own unique biological characteristics and behavior. Subdivisions of these neoplasms include low-grade astrocytomas (LGAs),pilocytic astrocytomas, oligodendrogliomas, gangligliomas,dysembryonic neuroepithelial tumors,pleomorphic xanthoastrocytomas, and subependymal giant cell astrocytomas. As each subgroup is overall clinically distinct, this chapter will focus primarily on the most common type of low-grade glioma-the astrocytomas. We will also further restrict our review to grade I and grade II astrocytomas, as defined by the Kernohan classifications, or grade II tumors, as categorized by Daumas-Duport. Although some of the observations and recommendations suggested by this chapter may also apply to other types of low-grade gliomas, the lack of consistent literature on these rarer entities makes them even more difficult to analyze

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alavi JB, Alavi A, Chawluk J, et al. (1988) Positron emission tomography in patients with gliomas: a predictor of prognosis.Cancer 62:1074-1078

    Google Scholar 

  • Adler JR (1993) Image-based frameless stereotactic radiosurgery.In: Maciunas RJ (ed) Interactive image-guided neurosurgery.American Association of Neurological Surgeons,Park Ridge, Illinois, pp 81-89

    Google Scholar 

  • Allen MB Jr, Johnston KW (1990) Preoperative evaluation:complications, their prevention and treatment. In:Youmans JR (ed) Neurological Surgery. WB Saunders,Philadelphia, pp 833-896

    Google Scholar 

  • Ammirati M, Vick N, Liao Y, Ciric U, Mikhael M (1987) Effect of the extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic astrocytoma. Neurosurgery 21:201-206

    Article  CAS  PubMed  Google Scholar 

  • Apuzzo MLJ (ed) (1995) Neurosurgical topics: benign cerebral glioma, vols. I, II. American Academy of NeurologicalSurgeons, Park Ridge, Illinois

    Google Scholar 

  • Apuzzo MLJ, Heifetz MD, Weiss MH, Kurze T (1977)Neurosurgicalendoscopy using the side-viewing telescope.Technical note. J Neurosurg 46:398-400

    Article  CAS  PubMed  Google Scholar 

  • Apuzzo MLJ, Sabshin JK (1983) Computed tomographic guidance stereotaxis in the management of intracranial mass lesions. Neurosurgery 12:277-285

    Article  CAS  PubMed  Google Scholar 

  • Apuzzo MLJ, Chandrasoma PT, Cohen D, Zee CS, Zelman V (1987) Computed imaging stereotaxy: Experience and perspective related to 500 procedures applied to brain masses. Neurosurgery 20:930-037

    Article  CAS  PubMed  Google Scholar 

  • Bahary JP, Villemure JG, Choi S, et al (1996) Low-grade pure and mixed cerebral astrocytomas treated in the CT era. J Neurooncol 27:173-179

    Article  CAS  PubMed  Google Scholar 

  • Berger MS, Deliganis AV, Dobbins J, et al. (1994) The effect of extent of resection on recurrence in patients with low cerebral hemisphere gliomas. Cancer 74(6):1784-1791

    Article  CAS  PubMed  Google Scholar 

  • Berger MS, Ojemann GA, Lettich E (1990) Neurophysiological monitoring during astrocytoma surgery. Neurosurg Clin North Am 1:65-80

    CAS  Google Scholar 

  • Bernstein M, Laperriere N (1991) Radiation induced tumors of the nervous system. In: Gutin PH, Leibel SA, Sheline GE (eds) Radiation injury to the nervous system. Raven, NewYork, pp 455-472

    Google Scholar 

  • Bloom HJG (1982) Intracranial tumors: Response and resistance to therapeutic endeavors, 1970-1980. Int J Rad Onc Biol Phys 8:1083-1113

    Article  CAS  Google Scholar 

  • Bouchard J, Peirce BC (1960) Radiation therapy in the management of neoplasms of the central nervous system with a special note in regard to children: twenty years¡¯ experience 1939-1958. Am J Rad 84:610-628

    Google Scholar 

  • Brada M, Ford D, Ashley S, et al (1992) Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenoma. Br Med J 304:1343-1346

    Article  CAS  Google Scholar 

  • Brodwater B, Roberts D, Nakajima T, et al. (1992) Extracranial application of the frameless stereotactic operating microscope:Experience with the lumbar spine. Neurosurgery 32:209-213

    Article  Google Scholar 

  • Burger PC, Scheithauer BW, Vogel FS (1991) Surgical pathology of the nervous system and its coverings. Churchill Livingstone, New York, pp 196-208

    Google Scholar 

  • Cairncross JG, Laperriere NJ (1990) Low-grade gliomas: to treat or not to treat? A reply. Arch Neurol 47:1139-1140

    Article  Google Scholar 

  • Chamberlain MC, Murovic JA, Levin VA (1988) Absence of contrast enhancement on CT brain scans of patients with supratentorial malignant gliomas. Neurology 38:1371-1374

    Article  CAS  PubMed  Google Scholar 

  • Chandrasoma PT, Smith MM, Apuzzo MLJ (1989) Stereotactic biopsy in the diagnosis of brain masses: Comparison of results of biopsy and resected surgical specimen. Neurosurgery 24(2):160-165

    Article  CAS  PubMed  Google Scholar 

  • Ciric IS, Rosenblatt S (1993) Supratentorial craniotomies. In: Apuzzo MLJ (ed) Brain surgery complications avoidance and management. Churchill Livingstone, New York, pp 51-60

    Google Scholar 

  • Colombo F, Casentini L, Zanusso M, et al. (1988) Validity of stereotactic biopsy as a diagnostic tool. Acta Neurochirurgica Suppl 42:152-156

    Article  CAS  Google Scholar 

  • Conway LW (1973) Stereotaxic diagnosis and treatment of intracranial tumours, including an initial experience with cryosurgery for pinealomas. J Neurosurg 38:453-60

    Article  CAS  PubMed  Google Scholar 

  • Cunningham JM, Kimmel DW, Scheithauer, et al. (1997) Analysis of proliferation markers and p53 expression in gliomas of astrocytic origin: relationships and prognostic value. J Neurosurg 86:121-130

    Article  CAS  PubMed  Google Scholar 

  • Cushing H (1932) Intracerebral tumors: notes upon a series of two-thousand verified cases with surgical-mortality percentages pertaining thereto. Thomas, Springfield, Illinois

    Google Scholar 

  • Daumas-Duport C, Monsaingeon V, Nguyen JP (1984) Some correlations between histological and CT aspects of cerebral gliomas contributing to the choice of significant trajectories for stereotactic biopsies. Acta Neurochir, Suppl 33:185-194

    Google Scholar 

  • Daumas-Duport C, Scheihauer B, O¡¯Fallon J et al. (1988) Grading of astrocytomas. Cancer 62:2152-2165

    Article  CAS  PubMed  Google Scholar 

  • DeVita VT (1983) The relationship between tumor mass and resistance to chemotherapy. Cancer 51:1209-1220

    Google Scholar 

  • Dirks PB, Jay V, Becker LE (1994) Development of anaplastic changes in low-grade astrocytomas of childhood. Neurosurgery 34: 68-78

    Article  CAS  PubMed  Google Scholar 

  • Djerassi I, Kim JS, Rigger A (1985) Response of astrocytomas to high dose methotrexate with citrovorum factor rescue. Cancer 55:2741-2747

    Article  CAS  PubMed  Google Scholar 

  • Dohrmann GJ, Rubin JM (1985) Intraoperative diagnostic ultrasound. In: Wilkins RH, Rengachary SS (eds) Neurosurgery.McGraw-Hill, New York, pp 457-460

    Google Scholar 

  • Drayer BP, Johnson PC, Bird CR (1987) Magnetic resonance imaging and glioma. Barrow Neurol Inst Q 3:44-55

    Google Scholar 

  • Eagan RT, Dinapoli RP, Herman RC et al (1982) Combination carmustine (BCNU) and dihydrogalactilol in the treatment of primary brain tumors recurring after irradiation.Cancer Treat Rep 66:1647-49

    Google Scholar 

  • Elvidge AR, Penfield W, Cone W (1937) The gliomas of the central nervous system. A study of 210 verified cases. Res Nerv Ment Dis 16:107-181

    Google Scholar 

  • Elvidge AR, Martinez-Coll A (1956) Long term follow-up of 106 cases of astrocytoma. J Neurosurg 13:318-331

    Google Scholar 

  • Epstein F (1985) Ultrasound dissection. In: Wilkins RH,Rengachary SS (eds) Neurosurgery. McGraw-Hill, NewYork, pp 476-483

    Google Scholar 

  • Erye H, Crowley J, Townsend J, et al (1993) A randomized trial of radiotherapy versus radiotherapy plus CCNU for incompletely resected low-grade gliomas: A Southwest Oncology Group study. J Neurosurg 78:909-914

    Article  Google Scholar 

  • Fadul C, Wood J, Thaler H, et al. (1988) Morbidity and mortality of craniotomy for excision of supratentorial gliomas.Neurology 38:1374-1379

    Google Scholar 

  • Fazekas JT (1977) Treatment of grades i and ii brain astrocytomas.The role of radiotherapy. Int J Radiation Oncology Biol Phys 2:661-666

    Article  CAS  Google Scholar 

  • Francavilla TL, Miletich RS, DiChiro G et al. (1989) Positron emission tomography in the detection of malignant degeneration of low-grade gliomas. Neurosurgery 26:1-5

    Article  Google Scholar 

  • Fults D, Brockmeyer D, Tullous MW (1992) P53 mutation and loss of heterozygosity on chromosome 17 and 10 during human astrocytoma progression. Cancer Res 52:674-679

    CAS  PubMed  Google Scholar 

  • Gajjar A, Bhargava, Jenkins, et al. (1995) Low-grade astrocytoma with neuraxis dissemination at diagnosis. J Neurosurg 83:67-71

    Article  CAS  PubMed  Google Scholar 

  • Garcia DM, Fulling KH (1985) Juvenile pilocytic astrocytoma of the cerebrum in adults. J Neurosurg 63:382-386

    Article  CAS  PubMed  Google Scholar 

  • Garcia DM, Fulling KH, Marks JE (1985) The value of radiation therapy in addition to surgery for astrocytomas of the adult cerebrum. Cancer 55:919-927

    Article  CAS  PubMed  Google Scholar 

  • Glantz MJ, Burger PC, Herndon JE, Friedman AH, et al (1991) Influence of the type of surgery on the histologic diagnosis in patients with anaplastic gliomas. Neurology 41:1741-44

    Article  CAS  PubMed  Google Scholar 

  • Gol A (1961) The relatively benign astrocytomas of the cerebrum:A clinical study of 194 verified cases. J Neurosurg 18:501-506

    Article  Google Scholar 

  • Grossman RG (1993) Preoperative and surgical planning for avoiding complications. In: Apuzzo MLJ (ed) Brain surgery complications avoidance and management. Churchill Livingstone, New York, pp 99-109

    Google Scholar 

  • Guthrie BL, Laws ER (1990) Supratentorial low-grade gliomas.Neurosurg Clin N Amer 1:37-48

    Google Scholar 

  • Hakuba A, Liu S, Nishimura S (1986) The orbitozygomatic infratemporal approach: a new surgical technique. Surg Neurol 26: 271-276

    Article  CAS  PubMed  Google Scholar 

  • Hara A, Hirayoma H, Sakai N (1990) Correlation between nucleolar organizer region staining and Ki-67 immunostaining in human gliomas. Surg Neuro 33:320-324

    Article  CAS  Google Scholar 

  • Hara A, Nishimura Y, Sakai N, et al. (1995) Effectiveness of intraoperative radiation therapy for recurrent supratentorial low grade glioma. J Neurooncol 25:239-243

    Article  CAS  PubMed  Google Scholar 

  • Harsh GR (1999) Management of recurrent gliomas. In: Berger MS, Wilson CB (eds) Gliomas. WB Saunders, Philadelphia, pp 649-659

    Google Scholar 

  • Management of Low-Grade Gliomas: A Surgical Perspective 313

    Google Scholar 

  • Heilbrun MP (1996) Frameless stereotactic localization and guidance. In Youmans JR (ed) Neurological surgery: a comprehensive reference guide to the diagnosis and management of neurosurgical problems, 4th edn. WB Saunders, Philadelphia, pp 786--794

    Google Scholar 

  • Helseth A, Mork S (1989) Neoplasms of the central nervous system in Norway. III. Epidemiological characteistics of intracranial gliomas according to histology. APMIS 97:547-555

    Article  CAS  PubMed  Google Scholar 

  • Horrax G (1954) Benign (favorable) types of brain tumor: The end results (up to twenty years) with statistics of mortality and useful survival. NEJM 250(23):981-984

    Article  CAS  PubMed  Google Scholar 

  • Hoshino T, Rodriguez LA, Cho KG et al. (1988) Prognostic implications of the proliferative potential of low-grade astrocytomas. J Neurosurg 69:839-842

    Article  CAS  PubMed  Google Scholar 

  • Hoshino T, Nagashima T, Murovic J, et al. (1986) In situ cell kinetic studies on human neuroectodermal tumors with bromodeoxyuridine labeling. J Neurosurg 64:453-459

    Article  CAS  PubMed  Google Scholar 

  • Ikeda K, Yamashita J, Hashimoto M, et al (1991) Orbitozygomatic temporopolar approach for a high basilar tip aneurysm associated with a short intracranial internal carotid artery: A new surgical approach. Neurosurgery 28:105-110

    Article  CAS  PubMed  Google Scholar 

  • Ito S, Chandler KL, Prados MD, et al. (1994) Proliferative potential and prognostic implication of low-grade astrocytoma. J Neurooncol 19:1-9

    Article  CAS  PubMed  Google Scholar 

  • Janny P, Cure H, Mohr M, et al. (1994) Low grade supratentorial astrocytomas: management and prognostic factors. Cancer 73(7):1937-45

    Article  CAS  PubMed  Google Scholar 

  • Karim ABMF, Maat B, Hatlevoll R, et al (1996) A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European Organization for Research and Treatment of Cancer (EORTC) study 22844. Int J Radiat Oncology Biol Phys 36:549-556

    Google Scholar 

  • Kelly PJ,Daumas-Duport C,Scheithauer BW, et al. (1987) Stereotactic histologic correlations of computed tomography-and magnetic resonance imaging-defined abnormalities in patients with glial neoplasms. Mayo Clin Proc 62:450-459

    Article  CAS  PubMed  Google Scholar 

  • Kepes JJ, Rubinstein LJ, Eng LV (1979) Pleomorphic xanthoastrocytoma: a distinctive meningocerebral glioma of young subjects with relatively favorable prognosis. Cancer 44:1839-1852

    Article  CAS  PubMed  Google Scholar 

  • Kepes JJ (1994) Pitfalls and problems in the histopathologic evaluation of stereotactic needle biopsy specimens. Neurosurg Clin North Am 5:19-33

    CAS  Google Scholar 

  • Kernohan JW, Mabon RF, Svien HJ, et al. (1949) A simplified classification of gliomas. Proc Staff Meetings Mayo Clin 24:71-75

    CAS  Google Scholar 

  • Kim TS, Halliday AL, Hedley-Whyte ET, Convery K (1991) Correlates of survival and the Daumas-Duport grading system for astrocytomas. J Neurosurg 74(1):27-37

    Article  CAS  PubMed  Google Scholar 

  • Kleihues P, Volk B, Anagnostopoulos J, Kiessling M (1984) Morphological evaluation of stereotactic brain tumour biopsies. Acta Neurochir S33:171-181

    Google Scholar 

  • Kondziolka D, Lunsford LD, Martinez AJ (1984) Unreliability of contemporary neurodiagnostic imaging in evaluating suspected adult supratentorial (low-grade) astrocytoma. J Neurosurg 79:533-536, 1993

    Google Scholar 

  • Kornblith PL, Walker M (1988) Chemotherapy of gliomas. J Neurosurg 68:1-17

    Article  CAS  PubMed  Google Scholar 

  • Krouwer HG, Davis RL, Silver P et al. (1991) Gemistocytic astrocytomas: a reappraisal. J Neurosurg 74:399-406

    Article  CAS  PubMed  Google Scholar 

  • Krouwer HG, Prados MD (1995) Infiltrative astrocytomas of the thalamus. J Neurosurg 82(4):548-57

    Article  CAS  PubMed  Google Scholar 

  • Labrousse F, Daumas-Duport C, Batorski L, Hoshino T (1991) Histological grading and bromodeoxyuridine labeling index of astrocytomas. Comparative study in a series of 60 cases. J Neurosurg 75(2):202-205

    Article  CAS  PubMed  Google Scholar 

  • Laws ER, Taylor WF, Clifton MB (1984) Neurosurgical management of low-grade astrocytoma of the cerebral hemispheres. J Neurosurg 61:665-673

    Article  PubMed  Google Scholar 

  • Laws ER, Taylor WF, Bergstralh, et al. (1986) The neurosurgical management of low-grade astrocytoma. Clin Neurosurgery 33:575-588

    Google Scholar 

  • Le Bihan D, Douek M, Argyropoulou M, et al. (1993) Diffusionand perfusion magnetic resonance imaging in brain tumors. Top Magn Reson Imaging 5:25-31

    Article  CAS  PubMed  Google Scholar 

  • Leibel SA, Sheline GE, Wara WM, et al. (1975) The role of radiation therapy in the treatment of astrocytomas. Cancer 35:1531-1557

    Article  Google Scholar 

  • Leighton C, Fisher B, Bauman G, et al. (1997) Supratentorial low-grade glioma in adults: an analysis of prognostic factors and timing of radiation. J Clin Onc 15(4):1294-1301

    CAS  Google Scholar 

  • LeRoux PD, Berger MS, Wang K et al. (1992) Low-grade gliomas:comparison of intraoperative ultrasound characteristics with preoperative imaging studies. J Neurooncol 13:189-198

    CAS  Google Scholar 

  • Levy LF, Elvidge AR (1956) Astrocytoma of the brain and spinal cord: a review of 176 cases, 1940-1949. J Neurosurgery 13: 413-443

    Article  Google Scholar 

  • Loftus CM, Coperland BR, Carmel PW (1985) Cystic supratentorial gliomas: natural history and evaluation of modes of surgical therapy. Neurosurgery 17:19-24

    Google Scholar 

  • Lote K, Egeland T, Hager B, et al. (1997) Survival, prognostic factors, and therapeutic efficacy in low-grade glioma: A retrospective study in 379 patients. J Clin Oncol 15(9):3129-3140

    CAS  PubMed  Google Scholar 

  • Lunsford LD, Somaza S, Kondziolka D, et al: (1995) Survival after stereotactic biopsy and irradiation of cerebral nonanaplastic, nonpilocytic astrocytoma. J Neurosurg 82:523-529

    Article  CAS  PubMed  Google Scholar 

  • Mamelak AN, Prados MD, Obana WG, et al. (1994) Treatment options and prognosis for multicentric juvenile pilocytic astrocytomas. J Neurosurg 81:24-30

    Google Scholar 

  • McCormack BM, Miller DC, Budzilovich GN, et al (1992) Treatment and survival of low-grade astrocytoma in

    Google Scholar 

  • adults: 1977-1988. Neurosurgery 31(4):636-642

    Google Scholar 

  • Mcdermott MW, Krouwer HGJ, Asai A, et al. (1992) Comparison of CT contrast enhancement and BUDR labeling indices in moderately and highly anaplstic astrocytomas of the cerebral hemispheres. Can J Neurol Sci 19:34-39,1992

    Google Scholar 

  • Medbery CA, Straus KL, Steinberg SM, et al. (1988) Low-grade astrocytomas: Treatment results and prognostic variables. Int J Rad Onc. Biol. Phys. 15:837-841

    Article  Google Scholar 

  • Mittler MA, Walters BC, Stopa EG (1996) Observer reliability in histological grading of astrocytoma stereotactic biopsies. J Neurosurg 85:1091-1094

    Article  CAS  PubMed  Google Scholar 

  • Morantz RA (1995) Low grade astrocytomas. In: Kaye AH, Laws ER (eds) Brain tumors: an encyclopedic approach. Churchill Livingstone, Edinburgh, pp 433-448

    Google Scholar 

  • Morantz RA (1996) Low-grade astrocytomas. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 789-798

    Google Scholar 

  • Mulhern RK, Kun LE (1991) Changes in intellect associated with cranial radiation therapy. In: Gutin PH, Sheline GE (eds) Radiation injury to the nervous system. Raven, New York, pp 325-340

    Google Scholar 

  • Müller W, Afra D, Schroder R (1977) Supratentorial recurrences of gliomas. Morphological studies in relation to time intervals with astrocytomas. Acta Neurochirurgica 37:75-91

    Article  PubMed  Google Scholar 

  • North CA, North RB, Epstein JA, et al. (1990) Low-grade cerebral astrocytomas: survival and quality of life after radiation therapy. Cancer 66:6-14

    Article  CAS  PubMed  Google Scholar 

  • Ojemann RG (1995) Surgical principles in the management of brain tumors. In: Kaye AH, Laws ER (eds) Brain tumors: an encyclopedic approach. Churchill Livingstone, Edinburgh, pp 293-303

    Google Scholar 

  • Ojemann RG, Heros RC, Crowell RM (1988) Surgical management of cerebrovascular disease. Williams & Wilkins, Baltimore Ojemann RG, Martuza RL (1990) Acoustic neuromas. In: Youmans JR (ed) Neurological surgery. WB Saunders, Philadelphia, pp 3316

    Google Scholar 

  • Okazaki H, Scheithauer BW (1988) Atlas of neuropathology. JB Lippincott, Philadelphia, pp 59-65

    Google Scholar 

  • Palma L, Guidetti B (1985) Cystic pilocytic astrocytomas of the cerebral hemispheres. J Neurosurg 62:811-815

    Article  CAS  PubMed  Google Scholar 

  • Parkins CS, Darling JL, Gill SS, Revesz T, Thomas DG (1991) Cell proliferation in serial biopsies through human malignant brain tumors: measurement using Ki-67 antibody labelling. Br J Neurosurg 5:289-98

    Article  CAS  PubMed  Google Scholar 

  • Paulus W, Peiffer J (1989) Intratumoral histological heterogeneity of gliomas: aquantitative study. Cancer 64:442-447

    Article  CAS  PubMed  Google Scholar 

  • Philippon JH, Clemenceau SH, Fauchon FH, et al. (1993) Supratentorial low-grade astrocytomas in adults. Neurosurgery 32(4):554-559

    Article  CAS  PubMed  Google Scholar 

  • Piepmeier JM (1987) Observations on the current treatment of low-grade astrocytic tumors of the cerebral hemispheres. J Neurosurg 67:177-181

    Article  CAS  PubMed  Google Scholar 

  • Rabb CH, Apuzzo MLJ (1995) Stereotaxis in the diagnosis and management of brain tumors. In: Kaye AH, Laws ER (eds) Brain tumors: an encyclopedic approach. Churchill Livingstone, Edinburgh, pp 433-448

    Google Scholar 

  • Radhakrisnan K, Bohnen NI, Kurland LT (1993) Epidemiology of brain tumors. In: Morantz RA, Walsh J (eds) Brain tumors: a comprehensive text. Dekker, New York

    Google Scholar 

  • Ransohoff J, Kelly P, Laws E (1986) The role of intracranial surgery for the treatment of intracranial gliomas. Semin Oncol 13:27-37

    CAS  PubMed  Google Scholar 

  • Recht LD, Lew R, Smith TW (1992) Suspected low grade glioma: Is deferring treatment safe? Ann Neurol 31:431-436

    Article  CAS  PubMed  Google Scholar 

  • Revesz T, Scaravilli F, Coutinho L, et al. (1993) Reliability of histological diagnosis including grading in gliomas biopsied by image-guided stereotactic technique. Brain 116:781-793

    Article  PubMed  Google Scholar 

  • Ringertz N (1950) Grading of gliomas. Acta Pathol Microbiol Scand 27:51-64

    Article  CAS  PubMed  Google Scholar 

  • Roberts D, Strohbehn J, Hatch J, et al (1986) A frameless stereotactic integration of computerized tomographic imaging and the operating microscope. J Neurosurg 65:545-549

    Article  CAS  PubMed  Google Scholar 

  • Russell DS, Rubinstein LJ (1989) Pathology of tumors of the nervous system, 5th edn. Williams & Wilkins, Baltimore, pp 126-225

    Google Scholar 

  • Salcman M (1990) Radical surgery for low-grade glioma. Clin Neurosurg 36:353-366

    CAS  PubMed  Google Scholar 

  • Salcman M (1985) Supratentorial gliomas: clinical features and surgical therapy. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 579-590

    Google Scholar 

  • Sano K (1980) Temporopolar approach to aneurysms of the basilar artery at and around the distal bifurcation: technical note. Neurol Res 2: 361-367

    CAS  PubMed  Google Scholar 

  • Scanlon PW, Taylor WF (1979) Radiotherapy of intracranial astrocytomas: analysis of 417 cases treated from 1960 through 1969. Neurosurgery 5:301-308

    Article  CAS  PubMed  Google Scholar 

  • Scherer JH (1938) Structural development in gliomas. Am J Cancer 34:333-351

    Google Scholar 

  • Scherer JH (1940) Cerebral astrocytomas and their derivatives.Am J Cancer 40:159-198

    Google Scholar 

  • Schiffer D, Chio A, Giordana MT, et al. (1988) Prognostic value of histologic factors in adult cerebral astrocytoma. Cancer 61:1386-1393

    Article  CAS  PubMed  Google Scholar 

  • Schultheiss TE, Kun LE, Ang KK, et al (1995) Radiation response of the central nervous system. Int J Radiat Oncol Biol Phys 31:1093-1112

    Article  CAS  PubMed  Google Scholar 

  • Sekhar LN, Janecka IP (1993) Surgery of cranial base tumors. Raven, New York Shaw EG (1995) The low-grade glioma debate: Evidence defending the position of early radiation therapy. Clin Neurosurg 40:488-494

    Google Scholar 

  • Shaw EG (1990) Low-grade gliomas: to treat or not to treat? A radiation oncologist¡¯s viewpoint. Arch Neurol 47:1138-1139

    Article  CAS  PubMed  Google Scholar 

  • Shaw EG, Daumas-Duport C, Scheithauer BW, et a (1989) Radiation therapy in the management of low-grade supratentorialastrocytomas. J Neurosurg 70:853-861

    Article  CAS  PubMed  Google Scholar 

  • Sheline GE (1986) The role of radiation therapy in the treatment of low-grade gliomas. Clin Neurosurg 33:533-74

    Google Scholar 

  • Shibamoto Y, Kitakabu Y, Takahashi M, et al (1993) Supratentorial low-grade astrocytoma. Correlation of computed tomography findings with effect of radiation therapy and prognostic variables. Cancer 72:190-195

    Article  CAS  PubMed  Google Scholar 

  • Shitara N, McKeever PE, Whang-Peng J, et al: Flowcytometric and cytogenetic analysis of human cultured cell lines derived from high- and low-grade astrocytomas. Acta Neuropathol 60:40-48

    Google Scholar 

  • Sidransky D, Mikkelsen T, Schwechheimer K et al. (1992) Clonal expansion of p53 mutant cells is associated with brain tumor progression. Nature 355:846-847

    Article  CAS  PubMed  Google Scholar 

  • Silverman C, Marks JE (1981) Prognostic significance of contrast enhancement in low-grade astrocytomas of the adult cerebrum. Radiology 139:211-213

    CAS  PubMed  Google Scholar 

  • Sklar CA, Constine LS (1995) Chronic neuroendocrinological sequelae of radiation therapy. In J Radiat Oncol Biol Phys 31:1113-1121

    Article  CAS  Google Scholar 

  • Sofietti R, Chio A, Giordana MT, et al. (1989) Prognostic factors in well-differentiated cerebral astrocytomas in the adult. Neurosurgery 24(5):686-692

    Article  Google Scholar 

  • Stage WS, Stein JJ (1974) Treatment of malignant astrocytomas. Am J Rad 120:7-18

    CAS  Google Scholar 

  • Steiger HJ, Markwalder RV, Seiler RW, et al. (1990) Early prognosis of supratentorial grade 2 astrocytomas in adult patients after resection or stereotactic biopsy. Acta Neurochir 106:99-105

    Google Scholar 

  • Stewart DH Jr, Krawchenko J (1985) Patient positioning. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 452-460

    Google Scholar 

  • Taphoorn MJB, Schiphorst AK, Snoek FJ, et al. (1994) Cognitive functions and quality of life in patients with lowgrade gliomas: the impact of radiotherapy. Ann Neurology 36:48-54

    Article  CAS  Google Scholar 

  • Tarlov IM (1937) Effect of roentgenotherapy on gliomas. Arch Neurol Psychiatry 38:513-536

    Article  Google Scholar 

  • Management of Low-Grade Gliomas: A Surgical Perspective 315

    Google Scholar 

  • Tew JM Jr, Scodary DJ (1993) Supratentorial procedures -basic techniques and surgical positioning. In: Apuzzo MLJ (ed) Brain surgery complications avoidance and management. Churchill Livingstone, New York, pp 31-50

    Google Scholar 

  • Uihlein A, Colby MY, Layton DD et al. (1996) Comparison of surgery and surgery plus irradiation in the treatment of supratentorial gliomas. Acta Radiologica 5:67-78

    Article  Google Scholar 

  • Vavruch L, Nordenskjold B, Carstensen J, Enestrom S (1996) Prognostic value of flow cytometery and correlation to some conventional prognostic factors: a retrospective study of archival specimens of 134 astrocytomas. J Neurosurg 85(1):146-151

    Article  CAS  PubMed  Google Scholar 

  • Vertosick FT, Selker RG, Arena VC (1991) Survival of patients with well-differentiated astrocytomas diagnosed in the era of computed tomography. Neurosurgery 23:496-501

    Google Scholar 

  • Vigilanis MC, Sichey N, Poisson M, et al (1996) A prospective study of cognitive function following radiotherapy for supratentorial gliomas in young adults: 4 year results. Int J Radiat Oncol Biol Phys 35: 527-533

    Article  Google Scholar 

  • Wara WM (1985) Radiation therapy for brain tumors. Cancer 55:2291-2295

    Article  CAS  PubMed  Google Scholar 

  • Watne K, Hannisdal E, Nome O (1992) Combined intra-arterial chemotherapy followed by radiation in astrocytomas. J Neurooncol 14:73-80

    Article  CAS  PubMed  Google Scholar 

  • Warnick RE (1993) Tumors associated with phakomatoses. In: Morantz RA, Walsh J (eds) Brain tumors: a comprehensive text. Dekker, New York

    Google Scholar 

  • Weingart J, Olivi A, Brem H (1991) Supratentorial low grade astrocytomas in adults. Neursurg Q 1:141-159

    Article  Google Scholar 

  • Weir B, Grace M (1976) The relative significance of factors affecting post-operative survival in astrocyomas, grades I and II. Can J Neuro Sci 3:47-50

    CAS  Google Scholar 

  • Whitton AC, Bloom HJG (1990) Low grade glioma of the cerebral hemispheres in adults: A retrospective analysis of 88 cases. Int J Rad Onc Biol Phys 18:783-786

    Article  CAS  Google Scholar 

  • Wilson CB, Prados MD (1986) Surgery for low-grade glioma: Rationale for early intervention. Clin Neurosurgery 33:383-390

    Google Scholar 

  • Winger MJ, MacDonald DR, Cairncross JG (1989) Supratentorial anaplastic gliomas in adults. J Neurosurg 71:487-493

    Article  CAS  PubMed  Google Scholar 

  • Worthington C, Tyler JF, Villemare JG (1987) Stereotactic biopsy and positron emission tomography correlation of cerebral gliomas. Surg Neuro 27:87-92

    Article  CAS  Google Scholar 

  • Yasargil MG, Reichmann MV, Kubik S (1987) Preservation of the frontotemporal branch of the facial nerve craniotomy. Technical article. J Neurosurg 67:463-466

    Article  CAS  PubMed  Google Scholar 

  • Zuber P, Hamou M, de Tribolet N (1988) Identification of proliferating cells in human gliomas using the monoclonal antibody Ki-67. Neurosurgery 22:364-368

    Article  CAS  PubMed  Google Scholar 

  • Zülch KJ (1986) Brain tumors: their biology and pathology, 3rd edn. Springer-Verlag, Berlin Heidelberg New York pp 210-213

    Book  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, University of Southern California School of Medicine, 1200 North State Street, Suite 5046, Los Angeles, California, 90033, USA

    L. T. Khoo MD (Clinical Instructor)

  2. Department of Neurosurgery and Radiation, Oncology, Biology and Physicsy, University of Southern California School of Medicine, 1200 North State Street, Suite 5046, Los Angeles, California, 90033, USA

    M. L. J. Apuzzo MD (Edwin M. Todd and Trent H. Well Jr. Professor)

Authors
  1. L. T. Khoo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. L. J. Apuzzo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, University of Southern California, Keck School of Medicine 1441 Eastlake Avenue, Room G356, Los Angeles, CA, 90033-0804, USA

    Zbigniew Petrovich MD, FACR (Professor and Chairman) (Professor and Chairman)

  2. Department of Radiation Oncology, Hahnemann University Hospital, Broad & Vine Sts., Mail Stop 200, Philadelphia, PA, 19102, USA

    Luther W. Brady MD (Hylda Cohn/ American Cancer Society Professor of Clinical Oncology and Professor) (Hylda Cohn/ American Cancer Society Professor of Clinical Oncology and Professor)

  3. Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90033, USA

    Michael L. J. Apuzzo MD (Edwin M. Todd/Trent H. Wells, Jr. Professor of Neurological Surgery and Professor of Radiation Oncology) (Edwin M. Todd/Trent H. Wells, Jr. Professor of Neurological Surgery and Professor of Radiation Oncology)

  4. Department of Radiotherapy, Eberhard-Karls-Universität, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany

    Michael Bamberg MD

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Khoo, L.T., Apuzzo, M.L.J. (2003). Management of Low-Grade Gliomas: A Surgical Perspective. In: Petrovich, Z., Brady, L.W., Apuzzo, M.L.J., Bamberg, M. (eds) Combined Modality Therapy of Central Nervous System Tumors. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56411-6_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-56411-6_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-00627-5

  • Online ISBN: 978-3-642-56411-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation