Acta Neuropathologica

, Volume 108, Issue 1, pp 49–56

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


  • Yoshikazu Okamoto
    • International Agency for Research on Cancer
  • Pier-Luigi Di Patre
    • International Agency for Research on Cancer
  • Christoph Burkhard
    • International Agency for Research on Cancer
  • Sonja Horstmann
    • International Agency for Research on Cancer
  • Benjamin Jourde
    • International Agency for Research on Cancer
  • Michael Fahey
    • International Agency for Research on Cancer
  • Danielle Schüler
    • Cancer RegistryCanton of Zurich
  • Nicole M. Probst-Hensch
    • Cancer RegistryCanton of Zurich
  • M. Gazi Yasargil
    • Department of NeurosurgeryCollege of Medicine
  • Yasuhiro Yonekawa
    • Department of NeurosurgeryUniversity Hospital Zurich
  • Urs M. Lütolf
    • Department of RadiologyUniversity Hospital Zurich
  • Paul Kleihues
    • International Agency for Research on Cancer
    • International Agency for Research on Cancer
Regular Paper

DOI: 10.1007/s00401-004-0861-z

Cite this article as:
Okamoto, Y., Di Patre, P., Burkhard, C. et al. Acta Neuropathol (2004) 108: 49. doi:10.1007/s00401-004-0861-z


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 astrocytomaOligodendrogliomaOligoastrocytomaPopulation-based studySurvivalIncidence rate

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© Springer-Verlag 2004