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BioMed Research International
Volume 2015, Article ID 497610, 11 pages
Clinical Study

Second Surgery in Insular Low-Grade Gliomas

1Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy
2Neurology Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy
3Department of Medical and Biological Sciences, University of Udine, Udine, Italy
4Center for Mind/Brain Sciences (CIMeC), University of Trento, Trento, Italy
5Surgical Pathology Department, Santa Maria della Misericordia University Hospital, Udine, Italy
6Robotics, Brain and Cognitive Sciences Department, Italian Institute of Technology, Genoa, Italy
7Section of Human Physiology, University of Ferrara, Ferrara, Italy

Received 15 March 2015; Revised 15 August 2015; Accepted 31 August 2015

Academic Editor: Franco Fulciniti

Copyright © 2015 Tamara Ius et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Given the technical difficulties, a limited number of works have been published on insular gliomas surgery and risk factors for tumor recurrence (TR) are poorly documented. Objective. The aim of the study was to determine TR in adult patients with initial diagnosis of insular Low-Grade Gliomas (LGGs) that subsequently underwent second surgery. Methods. A consecutive series of 53 patients with insular LGGs was retrospectively reviewed; 23 patients had two operations for TR. Results. At the time of second surgery, almost half of the patients had experienced progression into high-grade gliomas (HGGs). Univariate analysis showed that TR is influenced by the following: extent of resection (EOR) (), ΔVT2T1 value (), histological diagnosis of oligodendroglioma (), and mutation of IDH1 (). The multivariate analysis showed that EOR at first surgery was the independent predictor for TR (). Conclusions. In patients with insular LGG the EOR at first surgery represents the major predictive factor for TR. At time of TR, more than 50% of cases had progressed in HGG, raising the question of the oncological management after the first surgery.