Abstract
The purpose of this study was to evaluate long-term survival in patients with nonpilocytic low-grade gliomas (LGGs). Records of 314 adult patients with nonpilocytic LGGs diagnosed between 1960 and 1992 at the Mayo Clinic, Rochester, Minnesota, were retrospectively reviewed. The Kaplan-Meier method estimated progression-free survival (PFS) and overall survival (OS). Median age at diagnosis was 36 years. Median follow-up was 13.6 years. Operative pathology revealed pure astrocytoma in 181 patients (58%), oligoastrocytoma in 99 (31%), and oligodendroglioma in 34 (11%). Gross total resection (GTR) was achieved in 41 patients (13%), radical subtotal resection (rSTR) in 33 (11%), subtotal resection in 130 (41%), and biopsy only in 110 (35%). Median OS was 6.9 years (range, 1 month-38.5 years). Adverse prognostic factors for OS identified by multivariate analysis were tumor size 5 cm or larger, pure astrocytoma histology, Kernohan grade 2, undergoing less than rSTR, and presentation with sensory motor symptoms. Statistically significant adverse prognostic factors for PFS by multivariate analysis were only tumor size 5 cm or larger and undergoing less than rSTR. In patients who underwent less than rSTR, radiotherapy (RT) was associated with improved OS and PFS. A substantial proportion of patients have a good long-term prognosis after GTR and rSTR, with nearly half of patients free of recurrence 10 years after diagnosis. Postoperative RT was associated with improved OS and PFS and is recommended for patients after subtotal resection or biopsy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 437-445 |
| Number of pages | 9 |
| Journal | Neuro-Oncology |
| Volume | 11 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 2009 |
Fingerprint
Keywords
- Adult
- Combined modality
- Low-grade glioma
- Radiation
- Surgery
ASJC Scopus subject areas
- Cancer Research
- Oncology
- Clinical Neurology
Cite this
Intracranial low-grade gliomas in adults : 30-Year experience with long-term follow-up at Mayo Clinic. / Schomas, David A.; Laack, Nadia N; Rao, Ravi D.; Meyer, Fredric B.; Shaw, Edward G.; O'Neill, Brian Patrick; Giannini, Caterina; Brown, Paul D.
In: Neuro-Oncology, Vol. 11, No. 4, 08.2009, p. 437-445.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intracranial low-grade gliomas in adults
T2 - 30-Year experience with long-term follow-up at Mayo Clinic
AU - Schomas, David A.
AU - Laack, Nadia N
AU - Rao, Ravi D.
AU - Meyer, Fredric B.
AU - Shaw, Edward G.
AU - O'Neill, Brian Patrick
AU - Giannini, Caterina
AU - Brown, Paul D.
PY - 2009/8
Y1 - 2009/8
N2 - The purpose of this study was to evaluate long-term survival in patients with nonpilocytic low-grade gliomas (LGGs). Records of 314 adult patients with nonpilocytic LGGs diagnosed between 1960 and 1992 at the Mayo Clinic, Rochester, Minnesota, were retrospectively reviewed. The Kaplan-Meier method estimated progression-free survival (PFS) and overall survival (OS). Median age at diagnosis was 36 years. Median follow-up was 13.6 years. Operative pathology revealed pure astrocytoma in 181 patients (58%), oligoastrocytoma in 99 (31%), and oligodendroglioma in 34 (11%). Gross total resection (GTR) was achieved in 41 patients (13%), radical subtotal resection (rSTR) in 33 (11%), subtotal resection in 130 (41%), and biopsy only in 110 (35%). Median OS was 6.9 years (range, 1 month-38.5 years). Adverse prognostic factors for OS identified by multivariate analysis were tumor size 5 cm or larger, pure astrocytoma histology, Kernohan grade 2, undergoing less than rSTR, and presentation with sensory motor symptoms. Statistically significant adverse prognostic factors for PFS by multivariate analysis were only tumor size 5 cm or larger and undergoing less than rSTR. In patients who underwent less than rSTR, radiotherapy (RT) was associated with improved OS and PFS. A substantial proportion of patients have a good long-term prognosis after GTR and rSTR, with nearly half of patients free of recurrence 10 years after diagnosis. Postoperative RT was associated with improved OS and PFS and is recommended for patients after subtotal resection or biopsy.
AB - The purpose of this study was to evaluate long-term survival in patients with nonpilocytic low-grade gliomas (LGGs). Records of 314 adult patients with nonpilocytic LGGs diagnosed between 1960 and 1992 at the Mayo Clinic, Rochester, Minnesota, were retrospectively reviewed. The Kaplan-Meier method estimated progression-free survival (PFS) and overall survival (OS). Median age at diagnosis was 36 years. Median follow-up was 13.6 years. Operative pathology revealed pure astrocytoma in 181 patients (58%), oligoastrocytoma in 99 (31%), and oligodendroglioma in 34 (11%). Gross total resection (GTR) was achieved in 41 patients (13%), radical subtotal resection (rSTR) in 33 (11%), subtotal resection in 130 (41%), and biopsy only in 110 (35%). Median OS was 6.9 years (range, 1 month-38.5 years). Adverse prognostic factors for OS identified by multivariate analysis were tumor size 5 cm or larger, pure astrocytoma histology, Kernohan grade 2, undergoing less than rSTR, and presentation with sensory motor symptoms. Statistically significant adverse prognostic factors for PFS by multivariate analysis were only tumor size 5 cm or larger and undergoing less than rSTR. In patients who underwent less than rSTR, radiotherapy (RT) was associated with improved OS and PFS. A substantial proportion of patients have a good long-term prognosis after GTR and rSTR, with nearly half of patients free of recurrence 10 years after diagnosis. Postoperative RT was associated with improved OS and PFS and is recommended for patients after subtotal resection or biopsy.
KW - Adult
KW - Combined modality
KW - Low-grade glioma
KW - Radiation
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=68949107664&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=68949107664&partnerID=8YFLogxK
U2 - 10.1215/15228517-2008-102
DO - 10.1215/15228517-2008-102
M3 - Article
C2 - 19018039
AN - SCOPUS:68949107664
VL - 11
SP - 437
EP - 445
JO - Neuro-Oncology
JF - Neuro-Oncology
SN - 1522-8517
IS - 4
ER -