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Occurrence of non-central nervous system cancers during postoperative follow-up of patients who underwent surgery for a WHO grade II glioma: implications for therapeutic management

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Abstract

Purpose

Survival is currently prolonged in WHO grade II glioma (GIIG). Although exceptionally described, long-term survivors may develop second primary cancers outside the central nervous system (CNS). Here, a consecutive series explored the association between non-CNS cancers (nCNSc) and GIIG in patients who underwent glioma resection.

Methods

Inclusion criteria were adult patients operated for a GIIG who experienced nCNSc following cerebral surgery.

Results

Nineteen patients developed nCNSc after GIIG removal (median time 7.3 years, range 0.6–17.3 years), including breast cancers (n = 6), hematological cancers (n = 2), liposarcomas (n = 2), lung cancers (n = 2), kidney cancers (n = 2), cardia cancers (n = 2), bladder cancer (n = 1), prostate cancer (n = 1) and melanoma (n = 1). The mean extent of GIIG resection was 91.68 ± 6.39%, with no permanent neurological deficit. Fifteen oligodendrogliomas and 4 IDH-mutated astrocytomas were diagnosed. Adjuvant treatment was administrated in 12 patients before nCNSc onset. Moreover, 5 patients underwent reoperation. The median follow-up from initial GIIG surgery was 9.4 years (range 2.3–19.9 years). Nine patients (47%) died in this period. The 7 patients who deceased from the second tumor were significantly older at nCNSc diagnosis than the 2 patients who died from the glioma (p = 0.022), with a longer time between GIIG surgery and the occurrence of nCNSc (p = 0.046).

Conclusion

This is the first study investigating the combination between GIIG and nCNSc. Because GIIG patients are living longer, the risk to experience second neoplasm and to die from it is increasing, especially in older patients. Such data may be helpful for tailoring the therapeutic strategy in neurooncological patients developing several cancers.

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Data availability statement

Data that were used in the present study are available from the corresponding author upon request.

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Funding

The author declares that no financial support was received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Av Augustin Fliche, 34295, Montpellier, France

    Hugues Duffau

  2. Team “Plasticity of Central Nervous System, Stem Cells and Glial Tumors,” National Institute for Health and Medical Research (INSERM), U1191 Laboratory, Institute of Functional Genomics, University of Montpellier, 34091, Montpellier, France

    Hugues Duffau

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Contributions

Author contributions to the study and manuscript preparation include the following: Conception and design: HD. Acquisition of data: HD. Analysis and interpretation of data: HD. Drafting the article: HD. Critically revising the article: HD. Reviewed submitted version of manuscript: HD. Approved the final version of the manuscript: HD. Study supervision: HD.

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Correspondence to Hugues Duffau.

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Duffau, H. Occurrence of non-central nervous system cancers during postoperative follow-up of patients who underwent surgery for a WHO grade II glioma: implications for therapeutic management. J Neurooncol 162, 237–244 (2023). https://doi.org/10.1007/s11060-023-04288-5

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