Surg-21. case-matched study of effect of intra-operative mri on extent of resection and clinical outcome in glioma patients undergoing surgical resection

Recent studies indicate that increased extent of resection of malignant gliomas correlates with extended survival. Intra-operative MRI (iMRI) has been purported as a tool to aid surgeons in increasing the extent of resection. While several institutions have adopted iMRI, no reports to our knowledge discuss the effects of discontinuing its use. From July 2004 to June 2008, our institution used an intra-operative 1.5T MRI scanner (iMRI) to aid in glioma resection surgery. However, when the institution moved physically into a new hospital, the iMRI unit was discontinued. Using a single surgeon retrospective database, we identified the 68 consecutive patients who underwent iMRI-assisted resection glioma surgery (19 grade II patients, 23 Grade III patients and 26 Grade IV) with. These patients were case-matched with patients undergoing resection by the same surgeon after iMRI was no longer available. The case and control groups were well-matched for age, gender, grade, location of tumor, proximity to eloquent cortex, primary vs. recurrent and preoperative volume. Use of iMRI was not significantly associated with improved extent of resection (mean 96% iMRI vs 94% p=0.3683), rate of gross total resection (60% iMRI vs 65% p=0.4948) or overall survival (3348 iMRI vs >3000 p=0.5488). Gross total resection and extent of resection greater than 90% was associated with improved survival for both groups, regardless of grade. However, patient age, and molecular markers were overall strong...
Source: Neuro-Oncology - Category: Cancer & Oncology Authors: Tags: SURGICAL THERAPY Source Type: research