Variations in the management of diffuse low-grade gliomas—A Scandinavian multicenter study

• DOI: 10.1093/nop/npab054
• Publication Date: 2021-09-04T09:51:38Z
• Authors: Bodil Karoline Ra...; Ole Solheim; Jiri Bartek; Alba Corell; Eddie de Dios; Sasha Gulati; Eirik Helseth; Klas Holmgren; Margret Jensdottir; Mina Lundborg; Eduardo Erasmo Me...; Ruby Mahesparan; Øystein Vesterli ...; Peter Milos; Henrietta Nittby ...; Lars Kjelsberg Pe...; Jon Ramm-Pettersen; Rickard L Sjöberg; Björn Sjögren; Kristin Sjåvik; Anja Smits; Gregor Tomasevic; Tomás Gómez Vecchio; Einar O Vik-Mo; Maria Zetterling; Øyvind Salvesen; Asgeir S Jakola
• Keywords: Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi; Cancer och onkologi; Neurologi; diagnostic imaging; Kirurgi; 610; Medicine (miscellaneous); Health Care Service and Management, Health Policy and Services and Health Economy; Original Articles; chemotherapy; 3. Good health; surgical oncology; 03 medical and health sciences; 0302 clinical medicine; adjuvant; Neurology; glioma; Cancer and Oncology; Surgery; radiotherapy; adjuvant; chemotherapy; diagnostic imaging; glioma; radiotherapy; surgical oncology

Abstract Background Early extensive surgery is a cornerstone in treatment of diffuse low-grade gliomas (DLGGs), and an additional survival benefit has been demonstrated from early radiochemotherapy selected “high-risk” patients. Still, there are number controversies related to DLGG management. The objective this multicenter population-based cohort study was explore potential variations diagnostic work-up between treating centers 2 Scandinavian countries with similar public health care systems. Methods Patients screened for inclusion underwent primary histopathologically verified WHO grade II glioma the time period 2012 through 2017. Clinical radiological data were collected medical records locally conducted research projects, whereupon differences inter-hospital explored. Results A total 642 patients included (male:female ratio 1:4), annual age-standardized incidence rates 0.9 0.8 per 100 000 Norway Sweden, respectively. Considerable observed preoperative work-up, tumor diagnostics, surgical strategies, techniques intraoperative guidance, as well choice timing adjuvant therapy. Conclusions Despite geographical case selection, organizations, existing guidelines, considerable While some can be attributed clinical implementation current scientific knowledge, reflect diagnostics treatment. Quantification these disparities renders possible identification patterns associated better or worse outcomes may thus represent step toward more uniform evidence-based care.