Prognostic implication of histopathological, immunohistochemical and clinical features of oligodendrogliomas: a study of 89 cases

Abstract

Histopathological, immunohistochemical and clinical parameters were correlated with survival in 89 cases of oligodendroglioma (65 patients with grade II and 24 patients with grade III of the WHO classification). Median survival time and 5-year survival rate were 3.5 years and 76% for patients with oligodendroglioma grade II and 0.875 years and 23% for patients with oligodendroglioma grade III. The tumor biopsy specimens were immunohistochemically analyzed for Ki 67 (MIB-1), vimentin, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE) and synaptophysin. MIB-1 nuclear labeling index ranged from 0.0% to 33.4%; vimentin-immunoreactive tumor cells were found in 25 cases. MIB-1 nuclear labeling index and vimentin immunoreaction showed a significant statistical correlation to the 5-year survival rate of the patients. Tumors with vimentin expression (n=25) and/or high MIB-1 labeling index (n=26) had a poorer prognosis than tumors lacking vimentin expression (n=57) and/or displaying a low MIB-1 labeling index (n=56). The expression of immunoreactivity for GFAP (n=53), NSE (n=23) and synaptophysin (n=15) appeared to be of no prognostic relevance. Patients with gross total tumor resection (n=47) had a median survival time and 5-year survival rate of 3.3 years and 84% compared to 1.2 years and 42% for patients with subtotal resection (n=41). The comparison between patients who underwent surgery alone (n=53) and those who had surgery plus postoperative radiation therapy showed no significant survival benefit from postoperative radiation therapy. In conclusion, tumor grade, MIB-1 labeling index, expression of vimentin and the extent of surgery are shown to be of prognostic relevance for patients with oligodendroglioma.

Characterization of oligodendrogliomas using short echo time 1H MR spectroscopic imaging

“…Immunohistochemical studies demonstrated that this metabolite ratio parallels with the cell proliferation index for Ki-67 (MIB-1) positive cells; 28 a parameter that was shown to be of prognostic relevance for patients with oligodendrogliomas. 28,29 In line with in vivo MRS, in vitro NMR analyses of surgically obtained tumor specimens of oligodendrogliomas show decreased levels of NAA and Cr, and an increased level of Cho compared with normal brain. 22,23,27,30,31 Other metabolic features that have been described include an elevated level of Ino.…”

“…Grading of oligodendroglial tumors according to the WHO criteria has been shown to be of prognostic relevance and a significant predictor of survival. 29,46 Furthermore, treatment of oligodendrogliomas may be deferred until there is clinical or radiological evidence of progression, unless patients have disabling symptoms or signs at presentation. 2 In this respect, MRS could be used as a non-invasive tool for low-grade oligodendrogliomas to monitor development into higher malignancy of these tumors.…”

Ki-67 is a Valuable Prognostic Factor in Gliomas: Evidence from a Systematic Review and Meta-analysis

“…Of the candidate studies, 13 articles failed to completely describe the available survival data. Finally, 51 published studies in total were included in the analysis after eliminating articles unsatisfying the selection criteria and duplicates (Jaros et al, 1992;Torp et al, 1992;Montine et al, 1994;Ellison et al, 1995;Heegaard et al, 1995;Kros et al, 1996;Coons et al, 1997;Pollack et al, 1997;Dehghani et al, 1998;McKeever et al, 1998;Ritter et al, 1998;Figarella-Branger et al, 2000;Rodriguez-Pereira et al, 2000;Ho et al, 2001;ReaveyCantwell et al, 2001;Zhong et al, 2001;Bredel et al, 2002;Pollack et al, 2002;Bowers, 2003;Chiang et al, 2003;Neder et al, 2003;Wessels et al, 2003;Zamecnik et al, 2003;Preusser et al, 2005;Uematsu et al, 2005;Kleinschmidt-DeMasters et al, 2006;Donato et al, 2007;Kanamori et al, 2008;Kuo et al, 2009;Laks et al, 2009;Li et al, 2009;Armstrong et al, 2010;Nabika et al, 2010;Watanabe et al, 2010;Yoshida et al, 2010;Habberstad et al, 2011;Margraf et al, 2011;Qiang et al, 2011;Shen et al, 2011;Zawrocki et al, 2011;…”

Corpus Callosal Oligodendroglioma: A Rare Entity

“…The extent of resection largely depends on the location of the tumor and its proximity to 'eloquent' areas of the brain. In most studies, the authors have concluded that more complete resection is associated with increased patient survival [10][11][12]. Post-surgery, radiation therapy is recommended for all patients with a diagnosis of anaplastic ODG regardless of the extent of resection.…”