The presence of necrosis and/or microvascular proliferation does not influence survival of patients with anaplastic oligodendroglial tumours: review of 98 patients
- Sarah F. SmithAffiliated withDepartment of Neurosurgery, Royal North Shore Hospital Email author
- , Judy M. SimpsonAffiliated withSchool of Public Health, University of Sydney
- , Janice A. BrewerAffiliated withDepartment of Anatomical Pathology, Royal North Shore Hospital
- , Lali H. S. SekhonAffiliated withDepartment of Neurosurgery, Royal North Shore Hospital
- , Michael T. BiggsAffiliated withDepartment of Neurosurgery, Royal North Shore Hospital
- , Raymond J. CookAffiliated withDepartment of Neurosurgery, Royal North Shore Hospital
- , Nicholas S. LittleAffiliated withDepartment of Neurosurgery, Royal North Shore Hospital
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Accurate prognosis for patients with anaplastic oligodendroglial gliomas is increasingly difficult to make. Characterisation of these tumours remains challenging, increasing proportions of oligodendroglial diagnoses in gliomas are reported, and no WHO 2000 grade IV exists for them, so that highly anaplastic tumours can only be grouped with glioblastoma (GBM) or with grade III oligodendroglioma, which have differing clinical behaviour. Longer survival times reported for patients with glioblastoma containing an oligodendroglial element (GBMO) suggest that a grade IV for oligodendroglial tumours might exist.
In patients with anaplastic gliomas containing an oligodendroglial element, we explored whether microvascular proliferation (MVP) and necrosis were associated with shorter survival, sufficient to create a grade IV. Biopsies for 98 patients with anaplastic oligodendroglioma, anaplastic oligoastrocytoma or tumours with an oligodendroglial and GBM element, discharged 1998–2004, were identified from databases at three allied neurosurgery units. Pathology reports were reviewed for the presence of MVP and necrosis. Anaplastic oligoastrocytoma and GBMO were combined to measure the effect of an astrocytic element on survival.
For anaplastic oligodendroglioma patients, median survival time was 24 months, while for anaplastic oligoastrocytoma or GBMO patients, it was 9 months. Age 60 or over (P = 0.006) and astrocytic element (P = 0.01) were the only independent predictors of survival. Patients 60 and over with an astrocytic element had 4.6 times the risk of death of patients under 60 with anaplastic oligodendroglioma.
A grade IV cannot be created using necrosis or MVP since neither feature predicted survival after adjustment for age and an astrocytic element. However age and an astrocytic element were strong predictors of poorer survival in patients with anaplastic oligodendroglial tumours.
KeywordsGlioblastoma Glioblastoma with oligodendroglial element Microvascular proliferation Oligoastrocytoma Oligodendroglioma Prognosis Survival analysis Tumour grading Tumour necrosis
- The presence of necrosis and/or microvascular proliferation does not influence survival of patients with anaplastic oligodendroglial tumours: review of 98 patients
Journal of Neuro-Oncology
Volume 80, Issue 1 , pp 75-82
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Plenum Publishers
- Additional Links
- Glioblastoma with oligodendroglial element
- Microvascular proliferation
- Survival analysis
- Tumour grading
- Tumour necrosis
- Industry Sectors
- Author Affiliations
- 1. Department of Neurosurgery, Royal North Shore Hospital, St. Leonards, NSW, Australia, 2065
- 2. School of Public Health, University of Sydney, St. Leonards, NSW, Australia, 2006
- 3. Department of Anatomical Pathology, Royal North Shore Hospital, St. Leonards, NSW, Australia, 2065