Association of Extent of Resection and Functional Outcomes in Diffuse Low-Grade Glioma: Systematic Review & Meta-Analysis
Notice bibliographique
Résumé
Abstract Background Surgical resection offers survival benefits in patients with diffuse low-grade glioma (DLGG) but its association with functional outcomes is uncertain. This systematic review assessed functional outcomes associated with extent of resection (EoR) in adults with DLGG. Methods We searched Medline, Embase and CENTRAL on the 19 th of February 2021 for observational studies reporting functional outcomes after surgical resection for patients aged ≥18 years with a new diagnosis of supratentorial DLGG according to any World Health Organization classification of primary brain tumors. The Newcastle-Ottawa Scale (NOS) informed our risk of bias assessments. The proportion of patients returning to work within 12 months entered a random-effects meta-analysis. PROSPERO registration number CRD42021238387. Results There were seven eligible moderate to high-quality (NOS >6) observational studies identified from 1,183 records involving 234 patients with DLGG. Functional outcomes reported included neurocognition (n=2 studies), performance status (n=3), quality of life (QoL) (n=1) and return to work (n=6). The proportion of patients who returned to work within 12 months of surgery was 84% (95% confidence interval [CI] 50-96%, I-squared=38%, 5 studies) for gross total resection, 66% (95% CI 14-96%, I 2 =57%, 5 studies) for subtotal resection, and 31% (95% CI 4-82%, I 2 = 0%, 4 studies) for partial resection. There was insufficient data on other functional outcomes for quantitative synthesis. Conclusion A higher proportion of DLGG patients returned to work following gross total resection compared with those who had a subtotal or partial resection. Further studies with standardized assessments can clarify the association between EoR and different functional outcomes. Importance of the Study The association between lower residual tumor volume and better survival in people with diffuse low-grade glioma (DLGG) has driven surgical research into maximizing resection. However, innovative interventions should be evaluated against both oncological outcomes and functional outcomes. This systematic review included all studies reporting post-operative functional outcomes stratified by the extent of resection in people aged ≥18 years with DLGG. Two studies reported neurocognition, three reported performance status, one reported quality of life, and six reported return-to-work. Our meta-analysis demonstrated a higher proportion of patients returning to work within 12 months for those who had gross total resection (84%) compared to subtotal (66%) and partial (31%) resections. Our results suggest that increased EoR may be associated with return-to-work, but direct comparative studies should verify this finding and could examine other important functional outcomes. Key Points Seven studies reported functional outcomes stratified by EoR in DLGG patients. Return-to-work (RTW) was the most reported functional outcome. 84% undergoing GTR of DLGG RTW within 12 months compared to STR (66%) or PR (31%).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,026 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,014 | 0,026 |
| Bibliométrie | 0,004 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».