Skip to main content

Advertisement

SpringerLink
Log in

Prognosis in patients with anaplastic oligoastrocytoma is associated with histologic grade

  • Clinical Study - Patient Studies
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Background

Anaplastic oligoastrocytomas (AOA) are relatively uncommon high-grade gliomas. While oligodendroglial elements are thought to be associated with better outcomes, the magnitude of the difference is not clear.

Methods

Between 1980 and 1999, Mayo Clinic and the NCCTG conducted 10 trials of radiation therapy and chemotherapy in adults with newly-diagnosed high-grade gliomas. All pathology slides were reviewed by one of the authors (BWS or CG). We grouped patients by cell type and grade, compared survival distributions by the log-rank statistic, and performed multiple variable analyses.

Results

Of 1368 patients, 68 (5%) had AOA, including 21 Grade 3 (OA3) and 47 grade 4 (OA4), 153 (11%) had anaplastic astrocytoma (AA), and 1147 (84%) had glioblastoma multiforme (GBM). Patients with OA3 survived significantly longer than those with OA4 (P = 0.0001) or AA (P = 0.0044). Patients with OA4 lived significantly longer than those with GBM (P = 0.0005). The same differences were noted for PFS. Prognostic factors for survival identified by multiple variable analysis were histology, age, ECOG performance score, and extent of surgical resection, but not treatment administered.

Conclusions

Patients with anaplastic oligoastrocytoma have distinct outcomes based upon grade (OA3 vs. OA4) and in comparison with pure astrocytoma (AA or GBM). Future trials which include more than one histologic entity need to report results by cell type and grade and account for the varying prognoses in interpreting treatment outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Donahue B, Scott CB, Nelson JS et al (1997) Influence of an oligodendroglial component on the survival of patients with anaplastic astrocytomas: a report of Radiation Therapy Oncology Group 83-02. Int J Rad Oncol Biol Phys 38:911–914

    Article  CAS  Google Scholar 

  2. Shaw EG, Scheithauer BW, O’Fallon JR, Davis DH (1994) Mixed oligoastrocytomas: a survival and prognostic factor analyses. Neurosurg 34:577–582

    Article  CAS  Google Scholar 

  3. Miller CR, Dunham CP, Scheithauer BW et al (2006) Significance of necrosis in grading of oligodendroglial neoplasms: a clinicopathologic and genetic study of newly diagnosed high-grade gliomas. J Clin Oncol 24:5419–5426

    Article  PubMed  Google Scholar 

  4. Glass J, Hochberg FH, Gruber ML, Louis DN, Smith D, Rattner B (1992) The treatment of oligodendrogliomas and mixed oligodendroglioma-astrocytomas with PCV chemotherapy. J Neurosurg 76:741–745

    PubMed  CAS  Google Scholar 

  5. Kyritsis AP, Yung WK, Bruner J, Gleason MJ, Levin VA (1993) The treatment of anaplastic oligodendrogliomas and mixed gliomas. Neurosurg 32:365–370

    Article  CAS  Google Scholar 

  6. Smith JS, Perry A, Borell TJ et al (2000) Alterations of chromosome arms 1p and 19q as predictors of survival in oligodendrogliomas, astrocytomas, and mixed oligoastrocytomas. J Clin Oncol 18:636–645

    PubMed  CAS  Google Scholar 

  7. Reifenberger J, Reifenberger G, Liu L, James CD, Wechsler W, Collines VP (1994) Molecular genetic analysis of oligodendroglial tumors shows preferential allelic deletions on 19q and 1p. Am J Pathol 145:1175–1190

    PubMed  CAS  Google Scholar 

  8. Bello MJ, Vaquero J, de Campos JM et al (1994) Molecular analysis of chromosome 1 abnormalities in human gliomas reveals frequent loss of 1p in oligodendroglial tumors. Int J Cancer 57:172–175

    Article  PubMed  CAS  Google Scholar 

  9. Maintz D, Fiedler K, Koopmann J et al (1997) Molecular genetic evidence for subtypes of oligoastrocytomas. J Neuropathol Exp Neurol 56:1098–1104

    PubMed  CAS  Google Scholar 

  10. Bello MJ, Leone E, Nebreda P et al (1995) Allelic loss at 1p and 19q frequently occurs in association and may represent early oncogenic events in oligodendroglial tumors. Int J Cancer 64:207–210

    Article  PubMed  CAS  Google Scholar 

  11. Giannini C, Scheithauer BW, Weaver AL et al (2001) Oligodendrogliomas: reproducibility and prognostic value of histologic diagnosis and grading. J Neuropathol Exp Neurol 60:248–262

    PubMed  CAS  Google Scholar 

  12. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

    Article  Google Scholar 

  13. Mantel N (1996) Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep 50:163–170

    Google Scholar 

  14. LeBlanc M, Crowley J (1992) Relative risk trees for censored survival data. Biometrics 48:411–425

    Article  PubMed  CAS  Google Scholar 

  15. Cox DR (1972) Regression models and life tables. J R Stat Soc [B] 34:187–220

    Google Scholar 

  16. Efron B (1979) Bootstrap methods: another look at the jackknife. Ann Stat 7:1–26

    Google Scholar 

  17. Sauerbrei W, Schumacher M (1992) A bootstrap resampling procedure for model building: application to the Cox regression model. Stat Med 11:2093–2109

    Article  PubMed  CAS  Google Scholar 

  18. Walker MD, Alexander E Jr, Hunt WE et al (1978) Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg 49:333–343

    Article  PubMed  CAS  Google Scholar 

  19. Walker MD, Green SB, Byar DP et al (1980) Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med 303:1323–1329

    Article  PubMed  CAS  Google Scholar 

  20. Green SB, Byar DP, Walker MD et al (1983) Comparisons of carmustine, procarbazine, and high-dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma. Cancer Treat Rep 67:121–132

    PubMed  CAS  Google Scholar 

  21. Curran WJ Jr, Scott CB, Horton J et al (1993) Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst 85:704–710

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Jan C. Buckner

  2. Department of Biostatistics, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Judith R. O’Fallon & Karla V. Ballman

  3. Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Robert P. Dinapoli

  4. Department of Radiation Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Paula J. Schomberg

  5. Department of Pathology, Ochsner Clinic, 1514 Jefferson Hwy, New Orleans, LA, 70121, USA

    Gist Farr

  6. Medical Oncology, Toledo Clinic, 4235 Secor Road, Toledo, OH, 43623, USA

    Paul Schaefer

  7. Department of Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Caterina Giannini & Bernd W. Scheithauer

Authors
  1. Jan C. Buckner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Judith R. O’Fallon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert P. Dinapoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paula J. Schomberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gist Farr
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paul Schaefer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Caterina Giannini
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bernd W. Scheithauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Karla V. Ballman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jan C. Buckner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Buckner, J.C., O’Fallon, J.R., Dinapoli, R.P. et al. Prognosis in patients with anaplastic oligoastrocytoma is associated with histologic grade. J Neurooncol 84, 279–286 (2007). https://doi.org/10.1007/s11060-007-9370-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-007-9370-y

Keywords

Search

Navigation