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Eighty percent survival rate at 15 years for 1p/19q co-deleted oligodendroglioma treated with upfront chemotherapy irrespective of tumor grade

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Abstract

Introduction

Chromosomes 1p/19q co-deletion is a robust molecular marker for the diagnosis of oligodendroglial tumors, and has been included in the 2016 WHO modified classification. Although treatment for oligodendroglioma is controversial, upfront chemotherapy is regarded as one of the treatment option for low-grade tumor. We have treated all the 1p/19q co-deleted oligodendrogliomas, both grades II and III, with upfront chemotherapy without conventional radiotherapy for 20 years. The clinical experience from this trial may be suggestive for understanding of the biological features of oligodendroglioma with 1p/19q co-deletion toward precision medicine.

Methods

This is a long-term retrospective data of the non-selected patients with 1p/19q co-deleted oligodendrogliomas uniformly treated with up-front chemotherapy. Seventy consecutive patients (48 with grade II and 22 with grade III tumors) were included.

Results

The median follow-up period was 13 years. The 5-, 10-, and 15-year progression-free survival (PFS) rates were 85.7%, 54.8%, and 31.5%, respectively, and the median PFS was 146 months. In most cases, tumor recurrence was remained local and could be controlled by salvage surgery and/or chemotherapy. The 5-, 10-, and 15-year overall survival (OS) rates were 96.8%, 88.7%, and 80.0%, respectively, and the median OS was not reached. These survival data compared favorably with previous large clinical studies employing radiotherapy. Tumor grades based on World Health Organization classification, extent of surgery, and age affected neither PFS nor OS. Most patients were able to return to their premorbid social life.

Conclusions

The long-term results drawn from 20-years of single institution experience show that the patients with 1p/19q co-deleted oligodendrogliomas can be successfully treated with up-front chemotherapy alone without compromising OS.

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Authors and Affiliations

  1. Department of Neurological Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Chiba, Japan

    Yasuo Iwadate, Tomoo Matsutani, Ayaka Hara, Seiichiro Hirono, Shiro Ikegami, Masayoshi Kobayashi, Daisuke Ito, Daisuke Kawauchi, Kentaro Horiguchi, Ado Tamiya & Yoshinori Higuchi

Authors
  1. Yasuo Iwadate
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  2. Tomoo Matsutani
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  3. Ayaka Hara
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  4. Seiichiro Hirono
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  5. Shiro Ikegami
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  6. Masayoshi Kobayashi
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  7. Daisuke Ito
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  8. Daisuke Kawauchi
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  9. Kentaro Horiguchi
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  11. Yoshinori Higuchi
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Contributions

All the authors (YI, TM, AH, SH, SI, MK, DI, DK, KH, AT, YH) contributed to patient treatments and data collection. YI and TM prepared the manuscript.

Corresponding author

Correspondence to Yasuo Iwadate.

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The authors declare no conflicts of interest.

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Iwadate, Y., Matsutani, T., Hara, A. et al. Eighty percent survival rate at 15 years for 1p/19q co-deleted oligodendroglioma treated with upfront chemotherapy irrespective of tumor grade. J Neurooncol 141, 205–211 (2019). https://doi.org/10.1007/s11060-018-03027-5

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