Abstract Details

Title Intra-operative Monitoring with Electrocorticography Associates with Improved Survival Outcomes in High-grade Glioma

Topic Neuro-oncology

Presentation(s) P4 - Poster Session 4 (5:00 PM-6:00 PM)

Poster/Presentation
Number 6-007

Objective We characterize the impact of intra-operative monitoring (IOM) with electrocorticography (ECoG) on post-operative outcomes in patients undergoing resection of high-grade gliomas (HGG) to clarify the benefits of ECoG as a cortical mapping tool in the context of HGG resection.

Background Maximal safe resection is recommended as first-line treatment whenever possible in HGG. Prior research demonstrates a clear survival benefit for patients who receive a gross total resection (GTR) of their primary tumor. ECoG, a form of IOM used frequently in epilepsy surgery, has recently grown in popularity to promote maximal safe resection of brain tumors located in eloquent cortex. However, it has not known whether the use of ECoG confers additional clinical benefits to patients beyond increasing the likelihood of a GTR.

Design/Methods

We identified 648 patients with HGG who underwent surgical resection of their primary tumor; 311 patients had co-occurring epileptic activity. The Mann-Whitney U test compared median overall survival (OS) and progression-free survival (PFS) between patients with and without ECoG. Multivariable linear regression was used to assess the relationship between ECoG and post-operative outcomes (survival and seizure remission) while controlling for several additional variables, including age, anticancer treatments, gross total resection, and tumor location (lobe).

Results Median OS was significantly longer in patients who received ECoG (16.3 versus 14.0 months, P = 0.047). The association between ECoG and prolonged OS persisted in a multivariable linear regression (p = 0.013); no associations were seen with PFS. Although 80.6% of patients with tumor-associated epilepsy and ECoG achieved seizure remission compared to 71.7% without ECoG, this difference was not statistically significant (p = 0.260).

Conclusions The inclusion of ECoG during primary tumor resection in HGG associates with improved OS, even when accounting for tumor location and extent of tumor resection. ECoG may confer benefits during HGG primary tumor resection beyond facilitating the achievement of GTR.

Authors/Disclosures
Ryan Rilinger PRESENTER	Mr. Rilinger has nothing to disclose.
Lydia Guo	Ms. Guo has a non-compensated relationship as a Board of Directors with National Alzheimer's Buddies that is relevant to AAN interests or activities.
Akshay Sharma (Cleveland Clinic Foundations)	Akshay Sharma has nothing to disclose.
Josephine Volovetz, MD	Dr. Volovetz has nothing to disclose.
Matthew Grabowski	Matthew Grabowski has nothing to disclose.
Mina Lobbous, MD (Cleveland Clinic Foundation)	Dr. Lobbous has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Servier . Dr. Lobbous has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals . Dr. Lobbous has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Telix pharmaceuticals . Dr. Lobbous has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Springworks Pharmaceuticals . Dr. Lobbous has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Springworks Pharmaceuticals . Dr. Lobbous has received publishing royalties from a publication relating to health care.

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