TY - JOUR
T1 - Prognosis in patients with anaplastic oligoastrocytoma is associated with histologic grade
AU - Buckner, Jan C.
AU - O'Fallon, Judith R.
AU - Dinapoli, Robert P.
AU - Schomberg, Paula J.
AU - Farr, Gist
AU - Schaefer, Paul
AU - Giannini, Caterina
AU - Scheithauer, Bernd W.
AU - Ballman, Karla V.
PY - 2007/9
Y1 - 2007/9
N2 - 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.
AB - 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.
KW - Anaplastic astrocytoma
KW - Anaplastic oliogoastrocytoma
KW - Glioblastoma multiforme
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U2 - 10.1007/s11060-007-9370-y
DO - 10.1007/s11060-007-9370-y
M3 - Article
C2 - 17431544
AN - SCOPUS:34547160250
SN - 0167-594X
VL - 84
SP - 279
EP - 286
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 3
ER -