Early surgery for 'low-grade' brain tumours may result in longer survival

In collaboration with the Press Association

Early surgery for patients with slow-growing, low-grade glioma brain tumours may result in better survival than a wait-and-see approach, according to Norwegian research.

The study, published in the Journal of the American Medical Association (JAMA), compares strategies for treating the brain tumours at two Norwegian hospitals.

Patients at the hospital that usually carried out early surgery to removal low-grade brain tumour had better overall survival than at the hospital that usually carried out a biopsy followed by monitoring.

Until now, a lack of evidence has meant that treatment of the tumours - which are not usually considered surgically curable - has varied between different hospitals. Some doctors have thought close monitoring is best, to spare patients brain surgery. But others have considered surgery the best option to give their patients the best chances of survival.

The research compared 153 patients with brain tumours treated at one of the hospitals.

Patients treated at the hospital that usually carried out early surgery lived longer than patients treated at the hospital that usually took a biopsy and monitored the patients.

After one year, 89 per cent of patients from either hospital had survived their disease.

But after three years, 70 per cent of people at the biopsy and monitoring hospital had survived, compared with 80 per cent at the hospital that carried out early surgery. The gap for seven-year survival was even wider, at 44 per cent compared with 68 per cent.

Dr Asgeir Jakola, of St Olavs University Hospital in Trondheim carried out the study. He said that the results: "significantly strengthens the data in support of early resection in newly diagnosed low-grade gliomas."

Dr Colin Watts, a Cancer Research UK brain tumour expert at the University of Cambridge, said the question of how treat low-grade gliomas was challenging, as these slow-growing brain tumours can be present for years without causing symptoms.

He added: "This new paper is exciting, as it suggests that early surgery, rather than a 'watch and wait' strategy, is the best option for suitable patients.

"But there are still unanswered questions - for example, there were more oligodendrogliomas in the group who were operated on, and since these have a better prognosis, this could have skewed the results."

However, he said the results for astrocytomas, which have a poorer outlook, generally supported the idea that early surgery could the best treatment for some patients.

Copyright Press Association 2012

References

  • Jakola, A.S. Comparison of a Strategy Favoring Early Surgical Resection vs a Strategy Favoring Watchful Waiting in Low-Grade GliomasSurgical Resection vs Waiting in Low-Grade Gliomas, JAMA: The Journal of the American Medical Association, DOI: 10.1001/jama.2012.12807