SURGICAL INTERVENTION FOR CONTINUED GROWTH OF CEREBRAL GLIOMAS

INTRODUCTION. Neuroepithelial tumors occupy a leading position in frequency of occurrence, and relapse after or during combination treatment is inevitable in most cases. The lack of consensus on the indications and effectiveness of surgical treatment of recurrent gliomas served as the basis for the analysis of the results of surgical removal of recurrent gliomas.
THE AIM. Assess the effect of surgical removal of recurrent gliomas on overall life expectancy.
MATERIALS AND METHODS. A comparative analysis of overall survival among patients with recurrent gliomas of various degrees of malignancy (Grade II, III, and IV) was carried out in the surgical treatment groups for relapse (main) — 117 patients and conservative treatment (control) — 129 patients. All patients were treated in the Clinic of Neurosurgery of the Military Medical Academy from 1998 to 2018 inclusive.
RESULTS. With an increase in the degree of malignancy from Grade II to Grade IV in the main group, overall survival decreased from 84.9 months (Q1-Q3 = 61.1–132.8) to 26.4 months (Q1-Q3 = 14.9–50, 3). For patients of the control group — from 57.8 months (Q1-Q3 = 15.8 — not calculated) to 15.8 months (Q1-Q3 = 10.0–30.3), respectively. Among the completed cases in the surgical treatment group, life expectancy was statistically significantly increased by 40 months for patients with Grade II tumors compared with the control group (p <0.05) and clinically significant for patients with Grade IV and III tumors by 8.9 and 5, 9 months, respectively (p> 0.05).
CONCLUSION. Microsurgical recurrent glioma is a favorable factor for increasing the overall life expectancy in some patients with recurrent gliomas of any degree of malignancy. In case of gliomas of a low degree of malignancy, an additional basis for surgical intervention for relapse is to clarify the histological diagnosis in the development of relapse.

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