Prognostic factors in low grade (WHO grade II) gliomas of the cerebral hemispheres: the role of surgery.

Scerrati, Massimo; Roselli, R.; Iacoangeli, Maurizio; Pompucci, Angelo; Rossi, Giuseppe

doi:10.1136/jnnp.61.3.291

Cited by 126 publications

(57 citation statements)

References 42 publications

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“…Any study that reported better survival rates had included children, oligodendroglioma, WHO Grade 1 astrocytoma, predominantly lobar tumors, or had much shorter follow-up periods. [1][2][3][7][8][9]22 The well known 5-year experience is now extended to more than 10 years; Ten-year overall survival and 10-year progression-free survival were 37% and 21%, and 15-year survival and 15-year progression-free survival rates were 26% and 14%, respectively. Laws et al, who have presented long-term results of a large and heterogeneously composed study group treated before the advent of CT (by various degrees of tumor resection and external-beam radiation), reported 10-and 15-year survival rates of 21% and 18%, respectively.…”

Section: Outcomementioning

confidence: 95%

Interstitial ¹²⁵I radiosurgery of supratentorial de novo WHO Grade 2 astrocytoma and oligoastrocytoma in adults

Kreth

Faist

Grau

et al. 2006

Cancer

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BACKGROUNDDetailed long‐term outcome data are not available for adult patients with World Health Organization (WHO) Grade 2 astrocytoma or oligoastrocytoma.METHODSA previously published short‐term data set of 239 adult patients with circumscribed de novo supratentorial astrocytoma (187 patients) and oligoastrocytoma (52 patients) treated with interstitial iodine‐125 (125I) radiosurgery as primary treatment (1979–1992) was revisited. Survival, progression‐free survival, functionally independent survival, postrecurrence survival, and time to malignant transformation were estimated with the Kaplan–Meier method. Prognostic factors were obtained from the Cox multivariate proportional hazards model.RESULTSFive‐, 10‐, and 15‐year survival was 56%, 37%, and 26%, respectively (median follow‐up, 10.3 yrs). Progression‐free survival was 45%, 21%, and 14%, respectively. The corresponding malignant transformation rates were 33%, 54%, and 67%. No leveling off of the Kaplan–Meier curves could be observed for any of the chosen endpoints. Age > 50 years, a tumor volume > 20 mL, and/or a Karnofsky score ≤ 80 were associated with decreased survival or progression‐free survival. Age > 35 years and/or a tumor volume > 20 mL increased risk of malignant transformation. Prognostic factors determined subsets of patients with 10‐year survival ranging from as low as 6% to as high as 55% and progression‐free survival ranging 1–31%.CONCLUSIONSLong‐term tumor stabilization is rare. As outcome is mainly determined by treatment‐independent factors, minimization of any treatment‐related risk must be considered essential. Cancer 2006. © 2006 American Cancer Society.

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Section: Outcomementioning

confidence: 95%

Interstitial ¹²⁵I radiosurgery of supratentorial de novo WHO Grade 2 astrocytoma and oligoastrocytoma in adults

Kreth

Faist

Grau

et al. 2006

Cancer

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Current primary treatment options include surgical resection and/or radiotherapy, although definitive evidence for an optimal treatment remains elusive. Advances in molecular epidemiology indicate that certain histologic subtypes of low-grade gliomas, such as oligodendrogliomas, may have varied response to chemother- apeutic agents based on chromosomal changes, including loss of chromosome 1p and/or 19q, and, hence, may have improved survival with use of these agents.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the many projects [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] that have examined the association between both the use and the extent of surgical resection with outcomes for neurosurgical patients who are diagnosed with low-grade gliomas, 3 the relation remains unclear. In addition, although previous studies have examined the role of intraoperative magnetic resonance imaging (MRI) in tumor volume measurement, 18,20 the reports that exist generally are relatively small in size, present estimates that were not adjusted for age and/or histology, vary by study patient composition, or present study results in nonstandard statistical format.…”

mentioning

confidence: 99%

Survival rates in patients with low‐grade glioma after intraoperative magnetic resonance image guidance

Claus

Horlacher

Hsu

et al. 2005

Cancer

431

191

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Background We sought to examine hearing loss in a group from the Royal Australian Air Force who undertook fuel tank maintenance on F‐111 aircraft, with exposure to formulations containing ototoxins, relative to two different comparison groups. Methods Using pure‐tone audiometry, hearing thresholds were assessed in 614 exposed personnel, 513 technical‐trade comparisons (different base, same job), and 403 non‐technical comparisons (same base, different job). We calculated percentage loss of hearing (PLH) and used regression models to examine whether there was an association between PLH and F‐111 fuel tank maintenance, adjusting for possible confounders. In addition, the difference between the observed hearing thresholds and the expected thresholds based on an otologically normal population (ISO‐7029‐2003) was determined. Results The PLH ranged from nil to 96 (median 1.5, quartiles 0.3, 5.5). A logistic regression model showed no statistically significant difference in PLH among the three exposure groups (exposed vs. non‐technical controls 1.1: 95% CI 0.7, 2.0 and exposed vs. technical OR 0.9: 95% CI 0.6, 1.3). The model also highlighted a number of other risk factors for PLH including age, tinnitus, smoking, depression, and use of depression medications. However, at all eight frequencies measured, all populations had lower than expected hearing thresholds based on published ISO‐7029 medians. Conclusions Although there was no difference in PLH between the three exposure groups, the study did reveal a high degree of hearing loss between the 3 groups and a normal population. Am. J. Ind. Med. 53:1159–1169, 2010. © 2010 Wiley‐Liss, Inc.

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“…[1][2][3][4] Several studies have attempted to identify prognostic factors in LGG. 1,[5][6][7][8][9][10][11][12] Prognostic factors have various applications that could be of particular value in the heterogeneous population of LGG. This includes guidance for stratification in phase III trials and ultimately for treatment in individual patients.…”

Section: Ow-grade Gliomas (mentioning

confidence: 99%

Prognostic Factors for Survival in Adult Patients With Cerebral Low-Grade Glioma

Pignatti

Bent

Curran

et al. 2002

JCO

837

465

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P r o g n o s t i c F a c t o r s f o r S u r v i v a l i n A d u l t P a t i e n t s W i t h C e r e b r a l L o w -G r a d e G l i o m aPurpose: To identify prognostic factors for survival in adult patients with cerebral low-grade glioma (LGG), to derive a prognostic scoring system, and to validate results using an independent data set.Patients and Methods: European Organization for Research and Treatment of Cancer (EORTC) trial 22844 and EORTC trial 22845 are the largest phase III trials ever carried out in adult patients with LGG. The trials were designed to investigate the dosage and timing of postoperative radiotherapy in LGG. Cox analysis was performed on 322 patients from EORTC trial 22844 (construction set), and the results were validated on 288 patients from trial 22845 (validation set). Patients with pilocytic astrocytomas were excluded from this prognostic factor analysis.Results: Multivariate analysis on the construction set showed that age > 40 years, astrocytoma histology subtype, largest diameter of the tumor > 6 cm, tumor crossing the midline, and presence of neurologic deficit before surgery were unfavorable prognostic factors for survival. The total number of unfavorable factors present can be used to determine the prognostic score. Presence of up to two of these factors identifies the lowrisk group, whereas a higher score identifies high-risk patients. The validity of the multivariate model and of the scoring system was confirmed in the validation set.Conclusion: In adult patients with LGG, older age, astrocytoma histology, presence of neurologic deficits before surgery, largest tumor diameter, and tumor crossing the midline were important prognostic factors for survival. These factors can be used to identify lowrisk and high-risk patients. L OW-GRADE GLIOMAS (LGGs) are in general relatively slow-growing primary brain tumors, but they have a very heterogeneous clinical behavior. Many patients present with seizures only and remain stable for a prolonged period of time, whereas others present with functional deficits or signs of increased intracranial pressure that necessitate prompt surgical treatment. The best treatment policy for these tumors is still unclear. Some physicians advocate early and extensive surgery or early radiation therapy, 1-3 whereas others tend to postpone treatment until functional deficits are present. [1][2][3][4] Several studies have attempted to identify prognostic factors in LGG. 1,[5][6][7][8][9][10][11][12] Prognostic factors have various applications that could be of particular value in the heterogeneous population of LGG. This includes guidance for stratification in phase III trials and ultimately for treatment in individual patients. However, except for age, the importance of other prognostic factors for survival in LGG remains a matter of debate, and the need for validated prognostic factors has not been resolved. A number of patient and tumor characteristics, such as age at diagnosis, performance status, histology subtype, primary tumor classification (T clas...

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Prognostic factors in low grade (WHO grade II) gliomas of the cerebral hemispheres: the role of surgery.

Cited by 126 publications

References 42 publications

Interstitial ¹²⁵I radiosurgery of supratentorial de novo WHO Grade 2 astrocytoma and oligoastrocytoma in adults

Interstitial ¹²⁵I radiosurgery of supratentorial de novo WHO Grade 2 astrocytoma and oligoastrocytoma in adults

Survival rates in patients with low‐grade glioma after intraoperative magnetic resonance image guidance

Prognostic Factors for Survival in Adult Patients With Cerebral Low-Grade Glioma

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Prognostic factors in low grade (WHO grade II) gliomas of the cerebral hemispheres: the role of surgery.

Cited by 126 publications

References 42 publications

Interstitial 125I radiosurgery of supratentorial de novo WHO Grade 2 astrocytoma and oligoastrocytoma in adults

Interstitial 125I radiosurgery of supratentorial de novo WHO Grade 2 astrocytoma and oligoastrocytoma in adults

Survival rates in patients with low‐grade glioma after intraoperative magnetic resonance image guidance

Prognostic Factors for Survival in Adult Patients With Cerebral Low-Grade Glioma

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Interstitial ¹²⁵I radiosurgery of supratentorial de novo WHO Grade 2 astrocytoma and oligoastrocytoma in adults

Interstitial ¹²⁵I radiosurgery of supratentorial de novo WHO Grade 2 astrocytoma and oligoastrocytoma in adults