Gliomas
Conditions
Keywords
Microsurgery, Prognostic factor, Molecular biomarker, Survival analysis
Brief summary
The goal of this observational study is to learn if refined anatomical location-combined with molecular biomarkers-can predict surgical success and long-term survival in 450 adults and children with cerebellar gliomas who underwent microsurgical resection at a single center between 2014 and 2024. The main questions it aims to answer are: 1. Does tumor location (cerebellar hemisphere, vermis, fourth ventricle, or pontocerebellar-angle region) independently influence extent of resection and overall survival after adjustment for WHO grade and molecular profile? 2. Among IDH-wild-type low-grade gliomas, does gross-total resection plus early adjuvant radiotherapy improve 5-year overall and progression-free survival compared with lesser resection or radiotherapy omission? Researchers compared four anatomical subgroups and multiple molecular subtypes (IDH, 1p/19q, MGMT, TERT, BRAF V600E) to quantify location-specific resection rates, complication rates, and survival outcomes. Participants underwent standardized pre-operative imaging, microsurgical resection with intra-operative monitoring when indicated, post-operative MRI within 48 h to quantify residual tumor, and longitudinal clinical and radiographic follow-up every 3-12 months for up to 10 years.
Interventions
None listed
Sponsors
West China Hospital
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
3 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Pathologically proven cerebellar glioma (hemisphere, vermis, fourth ventricle, or pontocerebellar-angle region) per 2021 WHO CNS classification * First microsurgical resection performed at our center between January 2014 and January 2024 * Age ≥ 3 years at surgery * Pre-operative Karnofsky Performance Status (KPS) recorded * Availability of post-operative contrast MRI for resection-extent calculation * Minimum required molecular data: IDH1/2 status (immunohistochemistry ± sequencing) * Continuous follow-up ≥ 6 months after surgery (out-patient visits or telephone confirmation)
Exclusion criteria
* Brain-stem glioma with secondary cerebellar invasion * Recurrent or metastatic glioma * Previous cranial radiation or glioma surgery at another institution * Palliative resection (\< 20 % of tumor volume removed) * Missing post-operative MRI or insufficient tissue for mandatory IDH testing * Follow-up \< 6 months or lost to follow-up before 6-month landmark
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival (OS) time | 6 months | the number of months from the date of microsurgical resection to the date of death from any cause or last confirmed follow-up, measured for all 450 enrolled patients and compared across the four anatomical cerebellar locations and the predefined molecular sub-groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Progression-Free Survival (PFS) | 6 months | Time from surgery (or diagnosis) to radiographic or clinical tumor progression. Used to assess efficacy of resection and adjuvant therapies. |
| Extent of Resection (EOR) | 6 months | Categorized as: Gross Total Resection (GTR; ≥95% tumor removal) Subtotal Resection (STR; \<95%) Biopsy only Correlated with survival and recurrence risk. |
| Rate of Postoperative Complications | 6 months | Examples: Cerebellar mutism syndrome Wound infection / CSF leak Hematoma requiring reoperation Pseudomeningocele Need for ventriculoperitoneal (VP) shunt |
Countries
China
Outcome results
None listed