Analysis of the Surgical Edge of Adult-Type Diffuse Astrocytomas and its Correlation With Prognosis

INTRODUCTION: Glioma cells extend beyond the macroscopic margins of the tumor, making it impossible to pursue a cure based only on surgical treatment in patients with the diagnosis of Adult-Type Diffuse Glioma (ATDG). The tumor volume left behind in the surgical bed is a significant predictor of recurrence and survival. In the present study, we analyzed the grade of malignancy in the surgical edge (SE) after tumor removal and correlated it with progression-free survival (PFS) in patients diagnosed with ATDG. METHODS: Surgical edge biopsy samples were obtained after tumor removal in 15 patients (3 A2; 2 A3; 2 A4; and 8 GBM, WHO CNS 5); the samples were analyzed by three neuropathologists and were classified in a GOM (2, 3, or 4). An MRI was performed within 48 hours after surgery in all patients to assess the extent of resection. PFS was obtained from clinical and MRI follow-up. Data analysis was conducted using a nonparametric Spearman rank coefficient correlation test. RESULTS: Correlation analysis between the highest grade of malignancy found in the SE and PFS was -0.8080 (95% CI = -0.9359 to -0.4920, p < 0.0001). See Image 1. CONCLUSIONS: A strong correlation between the GOM in the SE and PFS was found in ATDG Astrocytomas. See Image 2 and 3.