RECURRENT BRAIN GLIOMA- SURGERY AND CLINICAL OUTCOME

Introduction: Gliomas account for 24% of all primary brain and CNS tumors. Histologically, gliomas were categorized into sub types and grades (I through IV). Low-grade gliomas are grade I and grade II, while high-grade gliomas are grade III and grade IV. The gold standard for treatment of high-grade glioma is the most extensive safe surgical resection followed by radiotherapy combined with chemotherapy. However, recurrence of glioma is inevitable. Management of recurrent cases is still controversy. Aim & Objective: The purpose of this research was to examine the efficacy of reoperation for cases of recurrent glioma in improving patients' outcome. Methods: This study included 40 patients with recurrent glioma admitted and operated. Results: There were 28 male (70%) and 12 female (30%), their age incidence ranged from 20 to 75 years with a mean age of 48.06, gross total resection of recurrent cases could be done in 24 (60%) patients, subtotal resection in 10 (25%) and partial in 6 (15%), all of recurrence were found at the same site almost the same of primary tumor except that two cases were radionecrosis and one patient revealed aggressive transformation from anaplastic astrocytoma to GBM by the end of the study period, and 26 (65%) patients alive and 14 (35%) died. Conclusion: Surgical management of recurrent gliomas in selected patients is generally associated with improved functional performance and prolonged survival. Patients' Karnofsky score at recurrence is an important prognostic factor for both low-grade glioma and high-grade glioma.