Journal of Neuro-Oncology

, Volume 34, Issue 1, pp 61–78 | Cite as

Oligodendrogliomas. Part II: A new grading system based on morphological and imaging criteria

  • Catherine Daumas-Duport
  • Marie-Louise Tucker
  • Harry Kolles
  • Pascale Cervera
  • Fréderic Beuvon
  • Pascale Varlet
  • Naoko Udo
  • Maria Koziak
  • Jean-Paul Chodkiewicz


This second part of our study of ‘pure’ oligodendrogliomas focuses on survival data analysis. In order to identify potentially useful prognostic factors and to assess the effectiveness of a new grading system, the 79 patients in the previously analyzed series for whom adequate follow-up could be obtained (52%) were entered in the present analysis. Statistical analysis demonstrated that contrast enhancement and endothelial hyperplasia had powerful and similar influence on survival. Median survival with and without contrast enhancement were: 3 versus 11 years, and with or without endothelial hyperplasia were: 3.5 versus 11 years. Conversely, the degree of nuclear atypia and presence or absence of mitosis or necrosis were not correlated with survival. These findings allowed us to devise a simple grading system which discriminates two malignancy grades as follows: absence of endothelial hyperplasia and of contrast enhancement=Grade A, presence of endothelial hyperplasia and/or of contrast enhancement=Grade B. Of the 79 oligodendrogliomas in this study, 59 tumors were categorized as grade A and 20 as grade B. Median survival were: 11 years in grade A and 3.5 years in grade B. Five-year and 8-year survival rates were: 89% and 60% in grade A and: 33% and 15% in grade B. Double blind grading between two independent observers was concordant in 96% of the cases. Application of this simple efficient and reproducible grading scheme should permit reliable comparison of retrospective or prospective therapeutic data emanating from various institutions.

oligodendroglioma grading system prognostic factors outcome radiology 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Earnest AR, Kernohan JW, Craig WMck: Oligodendrogliomas. Review of 200 cases. Archives of Neurology and Psychiatry 63: 964, 1950Google Scholar
  2. 2.
    Roberts M, German WJ: A long term study of patients with oligodendrogliomas. J Neurosurg 82: 84–89, 1982Google Scholar
  3. 3.
    Weir B, Elvidge AR: Oligodendrogliomas: an analysis of 63 cases. J Neurosurg 29: 500–505, 1968Google Scholar
  4. 4.
    Zander E, Klamlichi AE: Etude d'une série opératoire homogène de 35 cas d'oligodendrogliomes. Neurochirurgie 24: 37–46, 1978Google Scholar
  5. 5.
    Russel DS, Rubinstein LJ: Pathology of tumours of the nervous system. 147–153, 1971Google Scholar
  6. 6.
    Smith MT, Ludwig CL, Godfrey AD, Armbrustmacher VW: Grading of oligodendrogliomas. Cancer 52: 2107–2114, 1983Google Scholar
  7. 7.
    Ludwig CL, Smith MT, Godfrey AD, Armbrustmacher VW: A clinicopathological study of 323 patients with oligodendrogliomas. Ann Neurol 19: 15–21, 1986Google Scholar
  8. 8.
    Mork SJ, Halvorsen TB, Lindegaard KF, Eide GE: Oligodendroglioma. Histologic evaluation and prognosis. J Neuropathol Exp Neurol 45(1): 65–78, 1986Google Scholar
  9. 9.
    Martin V, Schmidt D: Malignancy grading of glial tumors. II. Oligodendrogliomas. Pathol Anat 31: 29–35, 1986Google Scholar
  10. 10.
    Burger PC, Rawlings CE, Cox EB, McLendon RE, Schold SC, Bullard DE: Clinicopathologic correlations in the oligodendroglioma. Cancer 59: 1345–1352, 1987Google Scholar
  11. 11.
    Wilkinson IMS, Anderson JR, Holmes AE: Oligodendroglioma: an analysis of 42 cases. J Neurol Neurosurg Psychiatry 50: 304–312, 1987Google Scholar
  12. 12.
    Kros JM, Troost D, Eden GV, Van Der Werf JM, Uylings BM: Oligodendroglioma: a comparison of two grading systems. Cancer 61: 2251–2259, 1988Google Scholar
  13. 13.
    Sun ZM, Genka S, Shitara N, Akanuma A, Takakura K: Factors possibly influencing the prognosis of oligodendroglioma. Neurosurgery 22(5): 886–891, 1988Google Scholar
  14. 14.
    Shaw EG, Scheithauer BW, O'Fallon JR, Tazelaar HD, Davis DH: Oligodendrogliomas: the Mayo Clinic experience. J Neurosurg 76: 428–434, 1992Google Scholar
  15. 15.
    Gannett DE, Wisbeck WM, Silbergeld DL, Berger MS: The role of postoperative irradiation in the treatment of oligodendroglioma. Int J Radiat Oncol Biol Phys 3 Vol. 30: 567–573, 1994Google Scholar
  16. 16.
    Kros JM, Pieterman H, Van Eden CG, Avezaat CJJ: Oligodendroglioma: the Rotterdam-Dijkzigt experience. Neurosurgery 34(6): 959–966, 1994Google Scholar
  17. 17.
    Celli P, Nofrone I, Palma L, Cantore G, Fortuna A: Cerebral oligodendroglioma: prognostic factors and life history. Neurosurgery 6 Vol. 35: 1018–1035, 1994Google Scholar
  18. 18.
    Alvord EC: Is necrosis helpful in the grading of gliomas? Editorial opinion. J Neuropathol Exp Neurol 21(2): 127–132, 1992Google Scholar
  19. 19.
    Daumas-Duport C: Histological grading of gliomas. Curr Opin Neurol Neurosurg 5: 924–931, 1992Google Scholar
  20. 20.
    Lopes BS, Vandenberg SR, Scheithauer BW: The pathology of oligodendrogliomas. In: Appuzo MLS (ed) Benign Cerebral Gliomas, Vol. 1. AANS 83–94, 1995Google Scholar
  21. 21.
    Mork SJ, Lindegaard KF, Halvorsey TB, Lehmann EH, Solgaard T, Hatlevoll R, Harvei S, Ganz J: Oligodendroglioma: incidence and biological behavior in a defined population. J Neurosurg 63: 881–889, 1985Google Scholar
  22. 22.
    Bruner JM: Oligodendroglioma: diagnosis and prognosis. Seminars in Diagnostic Pathology 4: 251–261, 1987Google Scholar
  23. 23.
    Russel DS, Rubinstein LJ: Pathology of Tumours of the Nervous System. 5th edition. Edward Arnold, London 172–186, 1989Google Scholar
  24. 24.
    Burger PC, Scheithauer BW: Oligodendroglial neoplasms. In: AFIP Atlas of Tumor Pathology, Series 3, Fascicle 10. Armed Forces Institute of Pathology, Washington, DC 107–120, 1994Google Scholar
  25. 25.
    Daumas-Duport C: Dysembryoplastic neuroepithelial tumours. Brain Pathol 3: 283–295, 1993Google Scholar
  26. 26.
    Daumas-Duport C: Patterns of tumor growth and problems associated with histological typing of low-grade gliomas. In: Benign Cerebral Glioma, Vol 1: 125–147, 1995Google Scholar
  27. 27.
    Wallner KE, Gonzales M, Sheline GE: Treatment of oligodendrogliomas with or without postoperative irradiation. J Neurosurg 68: 684–688, 1988Google Scholar
  28. 28.
    Daumas-Duport C: Histoprognosis of gliomas. Advances and Technical Standards in Neurosurgery 21: 43–72, 1994Google Scholar
  29. 29.
    Cutler SJ, Ederer E: Maximum utilisation of the life table method in analysing survival. J Chron Dis 8, 1958Google Scholar
  30. 30.
    Li ET: Statistical methods for survival data analysis. Lifetime Learning Publications, Belmont 1980Google Scholar
  31. 31.
    Sachs L: Applied Statistics. A Handbook of Techniques. Springer 1984Google Scholar
  32. 32.
    Daumas-Duport C, Blond S, Védrenne C, Szikla G: Radiolesion versus recurrence: bioptic data in 39 gliomas after interstitial, or combined interstitial and external radiation treatment. Acta Neurochirurgica, Suppl. 33: 291–299, 1984Google Scholar
  33. 33.
    Chin HW, Hazel JJ, Kim TH, Webster JH: Oligodendrogliomas. 1. A clinical study of cerebral oligodendrogliomas. Cancer 45: 1458–1466, 1980Google Scholar
  34. 34.
    Bullard DE, Rawlings CE, Phillips B, Cox EB, Clifford Schold S, Burger P, Halperin EC: Oligodendroglioma: an analysis of the value of radiation therapy. Cancer 60: 2179–2188, 1987Google Scholar
  35. 35.
    Lee YY, Van Tassel P: Intracranial oligodendrogliomas: imaging findings in 35 untreated cases. AJR 152: 361–369, 1989Google Scholar
  36. 36.
    Shimizu KT, Tran LM, Mark RJ, Selch MT: Management of oligodendrogliomas. Radiology 186: 569–572, 1993Google Scholar
  37. 37.
    Nijjar TS, Simpson WJ, Gadalla T, Math M, McCartney M: Oligodendroglioma. The Princess Margaret Hospital experience (1958- 1984). Cancer 12, Vol. 17: 4002–4006, 1993Google Scholar
  38. 38.
    Daumas-Duport C, Monsaingeon V, Blond S et al.: Serial stereotactic biopsies and CT scan in gliomas: correlative study in 100 astrocytomas, oligo-astrocytomas and oligodendrocytes. J Neurooncol 4: 317–328, 1986Google Scholar
  39. 39.
    Kelly PJ, Daumas-Duport C, Scheithauer BW et al.: Stereotactic histologic correlations of computed tomography-and magnetic resonance imaging-defined abnormalities in patients with glial neoplasm. Mayo Clin Proc 62: 450–459, 1987Google Scholar
  40. 40.
    Kelly PJ, Daumas-Duport C, Kispert DB: Imaging-based stereotactic serial biopsies in untreated intracranial glial neoplasms. J Neurosurg 66: 865–874, 1987Google Scholar
  41. 41.
    Kelly PJ: Tumor Stereotaxis. WB Saunders, Philadelphia 296–357, 1991Google Scholar
  42. 42.
    Hassoun J, Gambarelli D, Grisoli F, Pellet W, Salamon G, Pellissier JF, Toga M: Central neurocytoma. An electron-microscopic study of two cases. Acta Neuropathol (Berl) 56: 151–156, 1982Google Scholar
  43. 43.
    Hassoun J, Söylemezoglu F, Gambarelli D, Figarella-Branger D, Von Ammon K, Kleihues P: Central neurocytoma: a synopsis of clinical and histological features. Brain Pathol 3: 297–306, 1993Google Scholar
  44. 44.
    Kleihues P, Burger PC, Scheithauer BW: Histological typing of tumours of the central nervous system. In: World Health Organization. Springer-Verlag, Berlin p 16, 1993Google Scholar

Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • Catherine Daumas-Duport
    • 1
  • Marie-Louise Tucker
    • 1
  • Harry Kolles
    • 1
  • Pascale Cervera
    • 1
  • Fréderic Beuvon
    • 1
  • Pascale Varlet
    • 1
  • Naoko Udo
    • 2
  • Maria Koziak
    • 2
  • Jean-Paul Chodkiewicz
    • 2
  1. 1.Department of Pathology-NeurooncologyFrance
  2. 2.Department of NeurosurgeryHôpital Sainte-Anne and Faculté Cochin Port-RoyalParisFrance

Personalised recommendations