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Patterns of Interaction Between Diffuse Low-Grade Glioma and Pregnancy: An Institutional Case Series
Vasileios K Kavouridis1, Paola Calvachi2, Charles H Cho3
1Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway.
World Neurosurgery
|March 11, 2021
Summary
Pregnancy in low-grade glioma (LGG) patients presents challenges. While tumor growth rate showed no significant change, one-third experienced clinical deterioration, necessitating close monitoring.
Area of Science:
- Neuro-oncology
- Obstetrics and Gynecology
- Reproductive Medicine
Background:
- Pregnancy in low-grade glioma (LGG) patients is rare, posing unique therapeutic challenges.
- Limited existing literature addresses the clinical course and outcomes for this population.
- Understanding the impact of pregnancy on LGG is crucial for patient management.
Purpose of the Study:
- To retrospectively analyze the clinical course and obstetrical outcomes of patients with low-grade glioma (LGG) during pregnancy.
- To assess tumor growth rate in association with pregnancy using volumetric analysis.
- To provide evidence-based counseling for LGG patients considering pregnancy.
Main Methods:
- Retrospective identification of all patients diagnosed with LGG who experienced pregnancy.
- Review of clinical course and obstetrical outcomes for all identified patients.
- Volumetric analysis of tumor growth rate before, during, and after pregnancy.
Main Results:
- Of 15 women, 13 had pre-pregnancy LGG diagnosis; 2 were diagnosed during pregnancy.
- 60% remained asymptomatic, while 33.3% experienced seizure recurrence.
- No statistically significant change in tumor growth rate was observed during pregnancy (P = 0.306).
- One case of astrocytoma to glioblastoma transformation occurred during the third trimester.
Conclusions:
- Pregnancy is associated with clinical deterioration in approximately one-third of LGG patients.
- Tumor growth rate, time to progression, and malignant dedifferentiation appear unaffected by pregnancy.
- Counseling regarding potential complications and close neurological/obstetrical follow-up are recommended for pregnant LGG patients.
