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Diffuse low grade glioma and pregnancy: Practical considerations and clinical tips
Clinical Neurology and Neurosurgery ( IF 1.8 ) Pub Date : 2020-11-01 , DOI: 10.1016/j.clineuro.2020.106110
Teresa Somma 1 , Cinzia Baiano 1 , Laura Santi 2 , Giovanni Sabatino 3 , Giuseppe Maria Della Pepa 4 , Giuseppe La Rocca 3 , Paolo Cappabianca 1 , Alessandro Olivi 4 , Miran Skrap 5 , Tamara Ius 5
Affiliation  

OBJECTIVE The interaction between pregnancy and diffuse low-grade glioma (DLGG) is poorly investigated. The goal of this study was to provide further insights into the relationship between pregnancy and DLGG. METHODS A total of 12 patients were selected from a shared database of DLGGs, according to the following inclusion criteria: DLGG diagnosis in post-partum, DLGG recurrence after pregnancy in patients previously operated for DLGG. The extent of surgical resection (EOR) at first surgery were evaluated. All cases were assessed based on the 2016 WHO classification. The tumor growing patter, expresses by preoperative ΔT2T1 MRI index was evaluated. RESULTS In four cases newly diagnosed DLGG were detected patients in post-partum. Seven women, previously operated for DLGG, experienced pregnancy during the natural history of glioma, and were affected by tumor recurrence after pregnancy. One singular had an incidental LGG not surgically treated, who presented an important tumor growth after pregnancy. Radiological and surgical data were discussed according to literature. CONCLUSIONS Pregnancy does not seem to have an impact on the survival of women with DLGG. The potential role of pregnancy as risk factor in tumor recurrence is described, however, not proven. In this regard, the association between pregnancy and Tumor recurrence is extremely doubtful, and currently attributable to the simple coincidence. Further multicenter molecular investigations are required to better understand the mechanisms by which the pregnancy, in patients with a pervious surgery for DLGG, may influence tumor regrowth in comparison with the natural history of the disease.

中文翻译:

弥漫性低级别胶质瘤和妊娠:实际考虑和临床提示

目的 妊娠与弥漫性低级别胶质瘤 (DLGG) 之间的相互作用研究甚少。本研究的目的是进一步了解怀孕与 DLGG 之间的关系。方法从DLGGs共享数据库中选择12例患者,纳入标准如下:产后DLGG诊断,既往DLGG手术患者妊娠后DLGG复发。评估首次手术时的手术切除范围(EOR)。所有病例均根据 2016 年 WHO 分类进行评估。肿瘤生长模式,由术前ΔT2T1 MRI指数表示。结果4例初诊DLGG均在产后检出。7 名以前接受过 DLGG 手术的女性在神经胶质瘤的自然病程中经历了怀孕,并受孕后肿瘤复发的影响。一个单数有一个偶然的 LGG 没有接受手术治疗,在怀孕后出现了重要的肿瘤生长。根据文献讨论了放射学和手术数据。结论 妊娠似乎对 DLGG 妇女的生存没有影响。妊娠作为肿瘤复发危险因素的潜在作用已有描述,但尚未得到证实。就此而言,妊娠与肿瘤复发之间的关联极其可疑,目前归结为简单的巧合。需要进一步的多中心分子研究,以更好地了解与疾病的自然病程相比,接受过 DLGG 手术的患者怀孕可能影响肿瘤再生长的机制。
更新日期:2020-11-01
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