Spatial distribution of malignant transformation in patients with low-grade glioma

Background Malignant transformation represents the natural evolution of diffuse low-grade gliomas (LGG). This is a catastrophic event, causing neurocognitive symptoms, intensified treatment and premature death. However, little is known concerning the spatial distribution of malignant transformation...

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Bibliographic Details
Published in:Journal of neuro-oncology 2020, Vol.146 (2), p.373-380
Main Authors: Jakola, Asgeir S., Bouget, David, Reinertsen, Ingerid, Skjulsvik, Anne J., Sagberg, Lisa Millgård, Bø, Hans Kristian, Gulati, Sasha, Sjåvik, Kristin, Solheim, Ole
Format: Article
Language:English
Subjects:
Brain cancer
Cancer and Oncology
Cancer och onkologi
Clinical Study
Cognition
Glioma
Importation
Kirurgi
Magnetic resonance imaging
Medical disciplines: 700
Medicine
Medicine & Public Health
Medisinske Fag: 700
Neurologi
Neurology
Oncology
Patients
Radiation therapy
Spatial distribution
Surgery
VDP
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Summary:Background Malignant transformation represents the natural evolution of diffuse low-grade gliomas (LGG). This is a catastrophic event, causing neurocognitive symptoms, intensified treatment and premature death. However, little is known concerning the spatial distribution of malignant transformation in patients with LGG. Materials and methods Patients histopathological diagnosed with LGG and subsequent radiological malignant transformation were identified from two different institutions. We evaluated the spatial distribution of malignant transformation with (1) visual inspection and (2) segmentations of longitudinal tumor volumes. In (1) a radiological transformation site  10 ml in 93% of patients. The transformation site was considered local in 91% of patients by clinical assessment. Patients treated with radiotherapy prior to transformation had somewhat lower rate of local transformations (83%). Based upon the segmentations, the transformation was local in 92%. We did not observe any particular pattern of transformations in examined molecular subgroups. Conclusion Malignant transformation occurs locally and within the T2w hyperintensities in most patients. Although LGG is an infiltrating disease, this data conceptually strengthens the role of loco-regional treatments in patients with LGG.
ISSN:0167-594X
1573-7373
1573-7373
DOI:10.1007/s11060-020-03391-1