PMID- 33356607
OWN - NLM
STAT- MEDLINE
DCOM- 20230222
LR  - 20230222
IS  - 1360-046X (Electronic)
IS  - 0268-8697 (Linking)
VI  - 37
IP  - 1
DP  - 2023 Feb
TI  - Insular glioblastoma: surgical challenges, survival outcomes and prognostic 
      factors.
PG  - 26-34
LID - 10.1080/02688697.2020.1859089 [doi]
AB  - BACKGROUND: Insular gliomas are unique, challenging and evoke a lot of interest 
      amongst neurosurgeons. Publications on insular glioma generally focus on the 
      surgical intricacies and extent of resection pertaining to the low-grade gliomas. 
      Insular glioblastomas (iGBM) have not been analysed separately before. METHODS: 
      Histologically proven WHO grade IV gliomas involving the insula over a 9-year 
      period were studied. Their clinical presentation, radiological features, surgical 
      findings and survival outcomes were assessed. Statistical methods were used to 
      determine the favourable predictors of survival. RESULTS: Out of 27 patients 
      (M:F = 2.9:1), 18 (66%) patients had a tumour extension beyond the insula, 10 
      (37%) of whom had basal ganglia involvement. Total, near total and subtotal 
      excisions were performed in 7 (26%), 9 (33%) and 11 (40.7%) patients, 
      respectively. Twenty-three patients had glioblastoma, while four had gliosarcoma. 
      IDH mutation was negative in six of the seven patients where it was done. Median 
      overall survival was 5 months. Multivariate analysis showed that a female gender 
      (p = 0.013), seizures in the preoperative period (p = 0.048) and completion of 
      adjuvant therapy (p = 0.003) were associated with a longer survival. CONCLUSION: 
      Insular glioblastomas have a poor prognosis. Insular location and certain tumour 
      characteristics often limit the extent of resection of iGBMs. Moreover, 
      postoperative complications sometimes negate the advantages of a radical 
      resection. A female gender, presentation with seizures and completion of adjuvant 
      chemoradiotherapy appear to be good prognostic factors.
FAU - Singh, Amanjot
AU  - Singh A
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Das, Kuntal Kanti
AU  - Das KK
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Khatri, Deepak
AU  - Khatri D
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Singh, Suyash
AU  - Singh S
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Gosal, Jaskaran Singh
AU  - Gosal JS
AD  - Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), 
      Jodhpur, India.
FAU - Jaiswal, Sushila
AU  - Jaiswal S
AD  - Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Mishra, Prabhakar
AU  - Mishra P
AD  - Department of Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Mehrotra, Anant
AU  - Mehrotra A
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Bhaisora, Kamlesh
AU  - Bhaisora K
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Sardhara, Jayesh
AU  - Sardhara J
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Srivastava, Arun Kumar
AU  - Srivastava AK
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Jaiswal, Awadhesh
AU  - Jaiswal A
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Behari, Sanjay
AU  - Behari S
AD  - Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
LA  - eng
PT  - Journal Article
DEP - 20201226
PL  - England
TA  - Br J Neurosurg
JT  - British journal of neurosurgery
JID - 8800054
SB  - IM
MH  - Humans
MH  - Female
MH  - *Glioblastoma/diagnostic imaging/surgery/complications
MH  - *Brain Neoplasms/diagnostic imaging/surgery
MH  - Prognosis
MH  - Cerebral Cortex/pathology/surgery
MH  - *Glioma/surgery
MH  - Seizures/etiology
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Glioblastoma
OT  - extent of resection
OT  - insula
OT  - outcome
OT  - survival
EDAT- 2020/12/29 06:00
MHDA- 2023/02/22 06:00
CRDT- 2020/12/28 10:09
PHST- 2020/12/29 06:00 [pubmed]
PHST- 2023/02/22 06:00 [medline]
PHST- 2020/12/28 10:09 [entrez]
AID - 10.1080/02688697.2020.1859089 [doi]
PST - ppublish
SO  - Br J Neurosurg. 2023 Feb;37(1):26-34. doi: 10.1080/02688697.2020.1859089. Epub 
      2020 Dec 26.