BACKGROUND Current anaplastic oligodendroglioma (AO) management strategies involve surgical resection followed by adjuvant radiotherapy and/or chemotherapy. We investigated a subset of patients at our institution with AO, who, based on their treatment preferences, received surgery without any form of adjuvant therapy. This subset of patients was compared to a cohort with AO who received adjuvant therapy in order to investigate any differences in clinical and survival outcomes. METHODS A retrospective review of all AO patients treated by the senior author was undertaken between 1994 and 2018. A total of thirty-three cases were identified. Eleven had surgery alone, and twenty-two had surgery with adjuvant therapy. Progression free (PFS) and overall survival (OS) were compared between cohorts and potential confounders were addressed. RESULTS Gross total resection was achieved in 29 patients, and near total resection in 4 patients. PFS was not statistically different between patients treated with surgery alone versus patients receiving surgery plus adjuvant therapy (surgery alone: 84 ± 16 months; surgery with radiotherapy: 60 ± 9 months; p = 0.08). In addition, OS was also not statistically different between these groups (surgery alone: 215 ± 17 months; surgery with therapy: 241 ± 22 months; p = 0.44). CONCLUSIONS It is reasonable to consider a "watch and monitor" surveillance strategy in patients who decline adjuvant radiotherapy following surgical resection of their AO. Patients should be made aware that this treatment plan is not standard within current models of care for AO.

中文翻译：

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间变性少突胶质细胞瘤 – 最大手术切除后是否必须进行辅助放疗？

背景当前的间变性少突胶质细胞瘤（AO）管理策略包括手术切除，然后是辅助放疗和/或化疗。我们调查了我们机构中的一部分 AO 患者，这些患者根据他们的治疗偏好，在没有任何形式的辅助治疗的情况下接受了手术。将这部分患者与接受辅助治疗的 AO 队列进行比较，以研究临床和生存结果的任何差异。方法 对 1994 年至 2018 年间由资深作者治疗的所有 AO 患者进行回顾性研究。共确定了 33 例。11 人单独进行了手术，22 人进行了辅助治疗的手术。比较了队列之间的无进展 (PFS) 和总生存期 (OS)，并解决了潜在的混杂因素。结果 29 名患者实现了大体完全切除，4 名患者实现了接近完全切除。单纯手术治疗的患者与接受手术加辅助治疗的患者之间的 PFS 无统计学差异（单纯手术：84 ± 16 个月；手术加放疗：60 ± 9 个月；p = 0.08）。此外，这些组之间的 OS 也没有统计学差异（单独手术：215 ± 17 个月；手术治疗：241 ± 22 个月；p = 0.44）。结论 对于手术切除 AO 后拒绝辅助放疗的患者，考虑采用“观察和监测”监测策略是合理的。应让患者意识到该治疗计划在当前的 AO 护理模式中不是标准的。单纯手术治疗的患者与接受手术加辅助治疗的患者之间的 PFS 无统计学差异（单纯手术：84 ± 16 个月；手术加放疗：60 ± 9 个月；p = 0.08）。此外，这些组之间的 OS 也没有统计学差异（单独手术：215 ± 17 个月；手术治疗：241 ± 22 个月；p = 0.44）。结论 对于手术切除 AO 后拒绝辅助放疗的患者，考虑采用“观察和监测”监测策略是合理的。应让患者意识到该治疗计划在当前的 AO 护理模式中不是标准的。单纯手术治疗的患者与接受手术加辅助治疗的患者之间的 PFS 无统计学差异（单纯手术：84 ± 16 个月；手术加放疗：60 ± 9 个月；p = 0.08）。此外，这些组之间的 OS 也没有统计学差异（单独手术：215 ± 17 个月；手术治疗：241 ± 22 个月；p = 0.44）。结论 对于手术切除 AO 后拒绝辅助放疗的患者，考虑采用“观察和监测”监测策略是合理的。应让患者意识到该治疗计划在当前的 AO 护理模式中不是标准的。60±9个月；p = 0.08）。此外，这些组之间的 OS 也没有统计学差异（单独手术：215 ± 17 个月；手术治疗：241 ± 22 个月；p = 0.44）。结论 对于手术切除 AO 后拒绝辅助放疗的患者，考虑采用“观察和监测”监测策略是合理的。应让患者意识到该治疗计划在当前的 AO 护理模式中不是标准的。60±9个月；p = 0.08）。此外，这些组之间的 OS 也没有统计学差异（单独手术：215±17 个月；手术治疗：241±22 个月；p = 0.44）。结论 对于手术切除 AO 后拒绝辅助放疗的患者，考虑采用“观察和监测”监测策略是合理的。应让患者意识到该治疗计划在当前的 AO 护理模式中不是标准的。