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Tumor growth dynamics in serially-imaged low-grade glioma patients

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Abstract

Background

Diffuse low-grade gliomas (LGGs) are infiltrative, slow-growing primary brain tumors that remain relatively asymptomatic for long periods of time before progressing into aggressive and fatal high-grade gliomas.

Methods

We retrospectively identified LGG patients with numerous (≥ 8) serial magnetic resonance imaging (MRI) studies. Tumor volumes were measured by manual segmentation on serial imaging to study the natural history and growth of the lesion. Patient demographic information, tumor characteristics, and histological data were collected from electronic medical records and paper charts.

Results

Out of 74 LGG patients, 10 patients (13.5%) were identified to meet the study criteria with number of MRIs acquired ranging from 8 to 18 (median, 11.5) over a median of 79.7 months (range 39.8–113.8 months). Tumor diameter increased at a median of 2.17 mm/year in a linear trajectory. Cox regression analysis revealed that initial tumor volume was an independent predictor of time to clinical intervention, and Mann–Whitney U test found that patients younger than 50 years old had significantly slower-growing tumors. Clinical intervention was more likely for tumors above a volume threshold of 73.6 mL.

Conclusion

We retrospectively analyzed the natural history of LGGs of patients managed at a single institution with numerous serial MRI scans. Comparisons of our cohort to the literature suggest that this is a subset of particularly slow-growing and low-risk tumors.

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Funding

C.G. and S.E.K. received research scholarships from the Summer Research Training Program at the Schulich School of Medicine and Dentistry at Western University and the Mach-Gaensslen Foundation of Canada. J.C.L is funded through the Western University Clinical Investigator Program accredited by the Royal College of Physicians and Surgeons of Canada and a Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Doctoral Award Scholarship.

Author information

Author notes

  1. Jonathan C. Lau and Joseph F. Megyesi jointly directed this work.

Authors and Affiliations

  1. Department of Clinical Neurological Sciences (Neurosurgery), Western University, London, ON, Canada

    Chloe Gui, Suzanne E. Kosteniuk, Jonathan C. Lau & Joseph F. Megyesi

  2. Imaging Research Laboratories, Robarts Research Institute, London, ON, Canada

    Jonathan C. Lau

  3. Department of Pathology (Neuropathology), Western University, London, ON, Canada

    Joseph F. Megyesi

  4. London Health Sciences Centre, University Hospital, 339 Windermere Road, London, ON, N6A 5A5, Canada

    Jonathan C. Lau

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  1. Chloe Gui
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Corresponding author

Correspondence to Jonathan C. Lau.

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The authors have no conflicts of interests to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This work was approved as a retrospective chart review by Western University’s Research Ethics Board.

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Gui, C., Kosteniuk, S.E., Lau, J.C. et al. Tumor growth dynamics in serially-imaged low-grade glioma patients. J Neurooncol 139, 167–175 (2018). https://doi.org/10.1007/s11060-018-2857-x

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  • DOI: https://doi.org/10.1007/s11060-018-2857-x

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