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Influence of the type of surgery on the histologic diagnosis in patients with anaplastic gliomas

Duke University Medical Center (Drs. Glantz, Burger, Herndon, Friedman, and Schold), Durham, NC; London Regional Cancer Centre (Dr. Cairncross), London, England; and Evanston Hospital (Dr. Vick), Evanston, IL.

Stereotactic biopsy of CNS tumors provides a small amount of tissue for pathologic diagnosis. This potentially leads to inaccurate grading of gliomas because of their histologic heterogeneity. We compared histologic diagnoses in a consecutive series of 329 patients with newly diagnosed anaplastic gliomas whose diagnoses were established by either stereotactic biopsy or open resection. Of 262 patients undergoing resection, 214 (82%) had glioblastomas and 48 (18%) had anaplastic astrocytomas (AAs). Of 67 patients undergoing stereotactic biopsy, 33 (49%) had glioblastomas and 34 (51%) had AAs. This difference suggests that some AAs diagnosed by stereotactic biopsy are actually glioblastomas and has important implications for the design and interpretation of clinical trials.

Address correspondence and reprint requests to Dr. S. Clifford Schold, Jr., Duke University Medical Center, Division of Neurology, P.O. Box 3963, Durham, NC 27710.

Supported by NIH PO1-NS20023. Dr. Glantz was supported by a Training Grant from NINDS (#5T32-NS07304).

Received January 23, 1991. Accepted for publication in final form April 26, 1991.

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