Long-term surgical and seizure outcomes of frontal low-grade gliomas

• Seizure is the most common symptom in frontal low-grade gliomas.
• Duration of epilepsy and extent of resection are predictors of seizure outcome.
• Patients with worse seizure outcomes have tumour in the primary motor area.
• Patients with frontal low-grade gliomas benefit from postoperative rehabilitation.

IntroductionLow-grade gliomas are infrequent lesions requiring special emphasis because of their relatively long follow-up time, and therefore the need for patients' well-being. Surgery provides not only increased survival but also improved quality of life for these patients. The purpose of this study was to present surgical series of frontal low-grade gliomas that were operated in our clinic and to discuss their epileptic and functional outcomes.MethodsA series of 40 patients with low-grade glioma (WHO Grade II) were retrospectively analysed for patient characteristics, tumour location, epileptic history, surgery type (awake craniotomy, general anaesthesia), extent of resection and complications.ResultsTumour was localized to primary motor area in most of the cases (35%, n = 14), 25 patients were operated under general anaesthesia and 15 with awake craniotomy. New deficit rate in the early postoperative period was 32.5% (dysarthria in one patient and motor deficits in 12). Karnofsky scores were ≥90 in 92.5% of the patients at the late follow-up. 31 patients were Engel I (77.5%), 5 were Engel II (12.5%) and 4 were Engel IV (10%) postoperatively.ConclusionFrontal LGGs are eligible to resect vigorously without persistent functional deficits. Patients with immediate postoperative complications benefit from neuro-rehabilitation. However, pre-existing speech dysfunctions are hard to recover with surgery. Surgical resection ends with favourable epileptic outcomes whereas tumour location may influence the results.