Muto J, et al. - Experts intended to investigate the consequence of surgery on postoperative cognitive function and ability to work in adult patients harboring a diffuse low-grade glioma involving eloquent brain regions, with a functional-based maximal surgical resection, with the aid of intraoperative corticosubcortical mapping under awake conditions. Data shed light on the connection between the extent of the functional-based surgical resection and the residual tumor for diffuse low-grade gliomas involving eloquent brain regions with postoperative cognitive outcomes and return to work rates.

Methods

• The enrollment consisted of 39 consecutive diffuse IDH-mutant low-grade glioma patients without preoperative and adjuvant oncological treatment.
• A scrutiny was performed of the preoperative (mean 24.1±21.2 days before surgery) and postoperative (mean 14.6±13.2 months following surgery) cognitive evaluations and ability to work together with clinical, imaging, therapeutic, and follow-up characteristics before tumor progression.

Results

• Postoperative worsening was not found in either of the 3 patients without preoperative cognitive deficit.
• Findings disclosed a prominent inverse interaction between worsened postoperative cognitive function and extent of resection: 80.0%, 18.8%, and 16.7% of worsening following partial, subtotal, and total resection, respectively (p=0.020).
• An independent interaction was brought to light between improved postoperative cognitive function and extent of resection: 20.0%, 43.7%, and 44.4% of improvement following partial, subtotal, and total resection, respectively (p=0.022).
• As per the results, 61.8% of the employed patients were unable to work preoperatively, 82.4% of them resumed their employment postoperatively (mean, 6.9±5.5 months).
• Data illustrated an independent interaction between postoperative ability to work, similar or superior to preoperative work capacity and extent of resection (p < 0.001): 20.0%, 87.5%, and 100% ability to work following partial, subtotal resection and total resection.