Figure 4. Survival Curves for Highly Diffuse (low ρ/D), Moderately Diffuse (mid ρ/D), and Nodular (high ρ/D) for 243 Contrast-enhancing Gliomas.

Comparisons were made between biopsy/subtotal resection (BX/STR) and gross total resection (GTR) in all 243 contrast-enhancing gliomas. A–B) Comparing Bx/STR with GTR in 243 contrast enhancing gliomas at first surgical presentation, there is no significant survival benefit of GTR for highly and moderately diffuse (low and mid ρ/D, p = 0.532, p = 0.445, respectively). C) Patients with the least diffuse and most nodular pattern of growth (high ρ/D) that underwent GTR had a significant survival benefit over patients undergoing Bx or STR (p = 0.00142). Median increase in survival was 227 days (7.5 months) or a 65% improvement over the BX/STR population. When EOR was classified by percent of the T1Gd volume removed, with 76% selected as the cut off, the same selective survival benefit is observed in the nodular cohort (D–F, p = 0.00132). The limits between highly and moderately diffuse, and between moderately diffuse and nodular ρ/D were 0.376 mm⁻² and 1.30 mm⁻², respectively.