P07.11.A Impact of awake craniotomy on extent-of-resection and performance in glioma: a retrospective, propensity-score matched cohort study

نویسندگان

چکیده

Abstract Background The goal of awake craniotomy is to safely optimize the extent-of-resection in patients with glioma. Lower postoperative tumor volume associated better overall survival, emphasizing importance optimal surgical resection. Awake causes less neurological deficits than surgery under general anesthesia, however, it unclear whether leads lower compared anesthesia presumed grade Methods Retrospective, matched cohort study astrocytoma, IDH-mutant 2 and 3, oligodendroglioma, IDH-mutant, 1p/19q-codeleted low-grade glioma, IDH-wildtype (now designated glioblastoma, IDH-wildtype), who underwent resection or between 2003 2021 at Erasmus MC Brain Tumor Center. Pre- volumes were measured by semi-automatic 3D MRI-segmentation. First, we performed a multivariate logistic regression assess which factors predicted selection for craniotomy. Thereafter, matching based on propensity score was attempted. Outcome variables volume, percentage Karnofsky Performance Status (KPS) 3 months after surgery. Results We identified 181 craniotomy-patients 135 anesthesia-patients. younger, condition, more often male, tumors eloquent areas, left side brain non-contrast enhancing. When performing without replacement, only 68 could be anesthesia-patients, underscoring imbalance dataset. Matching replacement yielded dataset 60 anesthesia-patients adequate most baseline variables, except area (47% 21.7% p < 0.001). In this dataset, median 5.8 mL (IQR 0 - 92.8) vs 12.2 90.1) (p-value = 0.114). Resection percentages did not differ craniotomy- anesthesia-groups. KPS scores (p 0.15). Conclusion Postoperative Neither significantly different groups. Adequate obtainable using risk bias unmatched datasets. These data should interpreted care, given retrospective nature, potential residual confounding lack generalizability due normal patients.

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ژورنال

عنوان ژورنال: Neuro-oncology

سال: 2022

ISSN: ['1523-5866', '1522-8517']

DOI: https://doi.org/10.1093/neuonc/noac174.143