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ORIGINAL ARTICLE
Year : 2012  |  Volume : 60  |  Issue : 2  |  Page : 185--190

Surgery for recurrent malignant gliomas: Feasibility and perioperative outcomes

Aliasgar V Moiyadi, Prakash M Shetty 
 Department of Surgical Oncology, Neurosurgery Services, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India

Correspondence Address:
Aliasgar V Moiyadi
Department of Surgical Oncology, Neurosurgical Services, Room 48, Main Building, Tata Memorial Hospital, E Borges Road, Parel, Mumbai 400012
India

Background: Surgery for recurrent gliomas is often undertaken in select cases. Equivocal oncological outcomes of such surgeries are responsible for much of the controversy surrounding its role. Adding to the dilemma is the perceived increased morbidity associated with redo surgeries. Lack of studies and absence of uniformity in reporting outcomes is partly responsible for this. We evaluated our perioperative outcomes in recurrent malignant gliomas with the aim of documenting these objectively. Materials and Methods: A consecutive prospectively maintained database was queried for all redo surgeries in malignant gliomas performed at our referral neuro-oncology center. Demographic, clinical, surgical, and perioperative details were retrieved. Perioperative outcomes were objectively categorized as neurological (major/minor, transient/prolonged), regional, and systemic complications, along with overall morbidity and mortality. A similar analysis was performed for all craniotomies for intra-axial tumors. Results: Forty-one surgeries for recurrent malignant gliomas (from a database of 196 craniotomies for all intra-axial tumors) were evaluated. Neurological worsening occurred in 22.2% (12.2% major), whereas 44% showed improvement in the pre-existing deficits. Besides, regional and systemic complications occurred in 14.2% and 4.8%, respectively. Overall morbidity was 29.3% (major in 14.6%) and mortality was 2.4%. Though not significant on multivariate analysis, prior treatment was an important predictor of increased regional complications. Conclusions: Neurological morbidity after surgery for recurrent gliomas is acceptable. Surgery also provides a high chance of restoration of neurological function. Though regional complications can be significant and need to be given cognizance when reporting perioperative outcomes, they are not alarmingly high. Careful case selection can ensure optimization of these outcomes.


How to cite this article:
Moiyadi AV, Shetty PM. Surgery for recurrent malignant gliomas: Feasibility and perioperative outcomes.Neurol India 2012;60:185-190


How to cite this URL:
Moiyadi AV, Shetty PM. Surgery for recurrent malignant gliomas: Feasibility and perioperative outcomes. Neurol India [serial online] 2012 [cited 2020 Sep 26 ];60:185-190
Available from: http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2012;volume=60;issue=2;spage=185;epage=190;aulast=Moiyadi;type=0