Pregnancy increases the growth rates of world health organization grade II gliomas

Pallud, Johan; Mandonnet, Emmanuel; Deroulers, Christophe; Fontaine, Denys; Badoual, Mathilde; Laurent, Césari; Guillet-May, F.; Page, Philippe; Peruzzi, P; Jouanneau, Emmanuel; Frénay, M.; Cartalat‐Carel, Stéphanie; Duffau, Hugues; Taillandier, Luc

doi:10.1002/ana.21888

Cited by 88 publications

(50 citation statements)

References 15 publications

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“…Second, males tend to have more bad habits such as smoking and drinking than females have, meaning that males benefit more than females from the lifestyle change caused by marriage. In addition, in married female patients, pregnancy accelerates the progression of astrocytoma 30, 31, 32…”

Section: Discussionmentioning

confidence: 99%

Effect of marital status on survival in glioblastoma multiforme by demographics, education, economic factors, and insurance status

et al. 2018

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The relationship between marital status and glioblastoma multiforme (GBM) has not been addressed in depth. Here, we aimed to investigate the association between marital status and survival in GBM. We searched the Surveillance, Epidemiology, and End Results (SEER) database and extracted the data of eligible patients diagnosed with GBM after 2004. Marital status was classified as married, divorced/separated, widowed, and single. A Kaplan‐Meier test was conducted to compare the survival curves of different groups. Multivariate Cox regression was performed to evaluate overall survival (OS) and cause‐specific survival (CSS) in different groups. Subgroup analysis was applied according to demographics, typical education and income levels in the locale, and insurance status. A total of 30 767 eligible patients were included. The median OS values were 9, 7, 3, 9 months in married, divorced/separated, widowed, and single patients, respectively. After adjustment for other covariates, married patients had better OS and CSS than other patients had. In addition to marital status, demographic factors, disease progression factors, local educational level, and insurance status were also associated with survival in GBM. Furthermore, subgroup analyses revealed the protective effect of marriage in most of the comparisons. Notably, the protective effect of marriage becomes more and more apparent as time goes on. The advantageous effect of marriage on GBM survival is especially prominent in patients who are male, older than 60 years of age, White, or living in middle‐income counties. In conclusion, marital status is an independent prognostic factor for GBM.

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Section: Discussionmentioning

confidence: 99%

Effect of marital status on survival in glioblastoma multiforme by demographics, education, economic factors, and insurance status

et al. 2018

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“…LGG is a slow-growing tumor and the majority of pregnant women with kLGG give birth as planned and are less likely to receive any urgent therapy during pregnancy (7,8,10). Therefore, operative treatment during pregnancy for kLGG is extremely rare.…”

Section: Discussionmentioning

confidence: 99%

“…Advances in the therapeutic management of LGG during the last decade and improvements in its prognosis are expected to assist young women with LGG in becoming pregnant. A number of case series are found in the literature describing pregnant women with LGG, either detected prior to pregnancy or newly diagnosed during pregnancy (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). In either case, its management is a particularly challenging situation since i) anti-tumor therapy is required, although the impact on the fetus or the pregnancy would require consideration or ii) the pregnancy would have to be discontinued, depending on the severity of the disease and the gestational age (10).…”

Section: Introductionmentioning

confidence: 99%

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A case of pilocytic astrocytoma requiring tumor resection during pregnancy

Umehara

Okita

Nonaka

et al. 2016

Molecular and Clinical Oncology

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Abstract. Low-grade glioma (LGG) is often encountered in relatively young individuals, including women of childbearing age. Notably, case series describing pregnant women with LGG have been reported in the literature. The present study reported a case of pilocytic astrocytoma (PA) requiring tumor resection during pregnancy. The patient had a history of γ-knife radiotherapy for a brainstem tumor 17 years previously. The histological diagnosis was unclear. The tumor had remained stable following radiosurgery for 17 years, including during her first pregnancy. However, rapid tumor growth around the fourth ventricle occurred at week 25 of her second pregnancy. Therefore, an urgent tumor resection was performed despite the pregnancy. Partial resection was performed since the tumor had infiltrated the brainstem. The histological diagnosis was PA. The residual tumor volume decreased gradually following the delivery. Immunostaining of the tumor for the expression of progesterone receptor revealed focal staining. It is possible that reproductive factors, including specific hormonal changes during pregnancy, affected the tumor growth. The present study described this rare case of PA, which exhibited rapid growth and required urgent surgery during pregnancy. IntroductionLow-grade glioma (LGG) is often encountered in relatively young individuals, including women of childbearing age. Advances in the therapeutic management of LGG during the last decade and improvements in its prognosis are expected to assist young women with LGG in becoming pregnant. A number of case series are found in the literature describing pregnant women with LGG, either detected prior to pregnancy or newly diagnosed during pregnancy (1-10). In either case, its management is a particularly challenging situation since i) anti-tumor therapy is required, although the impact on the fetus or the pregnancy would require consideration or ii) the pregnancy would have to be discontinued, depending on the severity of the disease and the gestational age (10). Once a pregnancy with LGG is identified, patients, families, and neurosurgeons must recognize that they will encounter numerous difficult decisions at each stage of the pregnancy.The association between the behavior of the glioma and the pregnancy remains to be elucidated. Several previous studies have reported that the velocity of the diametric expansion of LGG increases during pregnancy (8) and that this acceleration may depend on multiple factors, including hormonal factors (11), growth factors (12), and hemodynamic changes (1,13), associated with pregnancy.Pilocytic astrocytoma (PA) is typically a slow-growing astrocytoma and is therefore, considered the 'most benign' of all the astrocytomas. It occurs predominantly in childhood and adolescence (14). Growth of PA during pregnancy is rarely reported. The present study reported a case in which PA growth occurred and urgent resection was required during pregnancy. The behavior of the glioma is focussed on during the pregnancy. Case reportA 30-year-old pregna...

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“…To our knowledge, only 2 other reports detail the effects of pregnancy on patients with LGG. These reports originate from the French glioma study group and feature information on the clinical symptoms and speed of tumor growth in 11 patients and 12 pregnancies.19, 21 The results indicate that there is a peri-gestational increase in lesion growth rates witnessed on MR images. However, is it still unknown how this affects outcome and survival.…”

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confidence: 99%

The effect of pregnancy on survival in a low-grade glioma cohort

Rønning

Helseth

Meling

et al. 2016

JNS

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A dult low-grade gliomas (LGGs; World Health Organization [WHO] Grade II) are progressive brain tumors with diffuse borders against normal brain tissue and have a propensity to spread in an infiltrative manner throughout the brain. 16 These tumors demonstrate a tendency to evolve into more aggressive highgrade gliomas (HGGs). WHO Grade I tumors are also usually termed "LGG." However, the nature of these lesions is quite different from their Grade II counterpart in that the Grade I tumor is not infiltrative and usually demonstrates more compact growth characteristics, making it more amenable to complete resection.LGGs compose approximately 15% of all gliomas. 26 Patients most often present with seizures, but they can also demonstrate neurological and cognitive deficits or complain of headache.2,26 There is a clear tendency for patients with these tumors to present earlier in life than those with higher-grade tumors, with the median age at diagnosis being between 40 and 50 years. 11Therefore, female patients are often diagnosed with LGG while within their reproductive years. As clinicians, we are often questioned and expected to counsel female patients on the issue of how pregnancy and delivery affects the biology of their LGG and, ultimately, their own survival. To our knowledge, only 2 other reports detail the effects of pregnancy on patients with LGG. These reports originate from the French glioma study group and feature information on the clinical symptoms and speed of tumor growth in 11 patients and 12 pregnancies.19, 21 The results indicate that there is a peri-gestational increase in lesion growth rates witnessed on MR images. However, is it still unknown how this affects outcome and survival.Since patients often present with seizures, they are

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Pregnancy increases the growth rates of world health organization grade II gliomas

Cited by 88 publications

References 15 publications

Effect of marital status on survival in glioblastoma multiforme by demographics, education, economic factors, and insurance status

Effect of marital status on survival in glioblastoma multiforme by demographics, education, economic factors, and insurance status

A case of pilocytic astrocytoma requiring tumor resection during pregnancy

The effect of pregnancy on survival in a low-grade glioma cohort

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