Regular Paper

Acta Neuropathologica

, Volume 108, Issue 1, pp 49-56

First online:

Population-based study on incidence, survival rates, and genetic alterations of low-grade diffuse astrocytomas and oligodendrogliomas

  • Yoshikazu OkamotoAffiliated withInternational Agency for Research on Cancer
  • , Pier-Luigi Di PatreAffiliated withInternational Agency for Research on Cancer
  • , Christoph BurkhardAffiliated withInternational Agency for Research on Cancer
  • , Sonja HorstmannAffiliated withInternational Agency for Research on Cancer
  • , Benjamin JourdeAffiliated withInternational Agency for Research on Cancer
  • , Michael FaheyAffiliated withInternational Agency for Research on Cancer
  • , Danielle SchülerAffiliated withCancer Registry, Canton of Zurich
  • , Nicole M. Probst-HenschAffiliated withCancer Registry, Canton of Zurich
  • , M. Gazi YasargilAffiliated withDepartment of Neurosurgery, College of Medicine
    • , Yasuhiro YonekawaAffiliated withDepartment of Neurosurgery, University Hospital Zurich
    • , Urs M. LütolfAffiliated withDepartment of Radiology, University Hospital Zurich
    • , Paul KleihuesAffiliated withInternational Agency for Research on Cancer
    • , Hiroko OhgakiAffiliated withInternational Agency for Research on Cancer Email author 

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We carried out a population-based study on low-grade diffuse gliomas in the Canton of Zurich, Switzerland (population 1.16 million). From 1980 to 1994, 987 astrocytic and oligodendroglial tumors were diagnosed, of which 122 (12.4%) were low-grade (WHO grade II). The incidence rates adjusted to the World Standard Population, per million population per year, were 2.28 for low-grade diffuse astrocytomas, 0.89 for oligoastrocytomas, and 2.45 for oligodendrogliomas. The survival rate (mean follow-up 7.5±4.8 years) was highest for patients with oligodendroglioma (78% at 5 years, 51% at 10 years), followed by those with oligoastrocytoma (70% at 5 years, 49% at 10 years) and fibrillary astrocytoma (65% at 5 years, 31% at 10 years). Survival of patients with gemistocytic astrocytoma was poor, with survival rates of 16% at 5 years and 0% at 10 years. Younger patients (<50 years) survived significantly longer than older patients (>50 years; P=0.013). DNA sequencing, performed in 84% of cases, revealed that TP53 mutations were most frequent in gemistocytic astrocytomas (88%), followed by fibrillary astrocytomas (53%) and oligoastrocytomas (44%), but were infrequent (13%) in oligodendrogliomas. The presence of TP53 mutations was associated with shorter survival of patients with low-grade diffuse gliomas (log-rank test; P=0.047), but when each histological type was analyzed separately, an association was observed only for oligoastrocytoma (P=0.05). Loss on 1p and 19q were assessed by quantitative microsatellite analysis in 67% of cases. These alterations were frequent in oligodendrogliomas (1p, 57%; 19q, 69%), less common in oligoastrocytomas (1p, 27%; 19q, 45%), rare in fibrillary astrocytomas (1p, 7%; 19q, 7%), and absent in gemistocytic astrocytomas. None of these alterations were predictive of survival. These results establish the frequency of key genetic alterations in low-grade diffuse gliomas at a population-based level. Multivariate Cox’s regression analysis indicates that only age and histological type, but not genetic alterations, are significant predictive factors.


Low-grade diffuse astrocytoma Oligodendroglioma Oligoastrocytoma Population-based study Survival Incidence rate