Shlomit Yust-Katz1, Mark Daniel Anderson, Diane Liu, Jimin Wu, Ying Yuan, Adriana Olar, Greg N Fuller, Paul D Brown, John F de-Groot. 1. Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (S.Y.-K., D.L., J.F.de-G.); Department of Neurology, The University of Mississippi Medical Center, Jackson, Mississippi (M.D.A.); Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (J.W., Y.Y.); Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O., G.N.F.); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (P.D.B.).
Abstract
BACKGROUND: Gangliogliomas (GGs) represent <1% of primary brain tumors in adults. Little is known regarding prognostic features, clinical characteristics, or the impact of treatment on patient outcomes. METHODS: Our neuro-oncology longitudinal database was screened for patients with GG from 1992 to 2012. Sixty-seven patients (age >18 y) were identified. RESULTS: Sixty-two patients presented with low-grade GG and 5 with anaplastic GG. The median age at diagnosis was 29 years. With a median follow-up of 4.7 years after the initial diagnosis, 23 patients had progressive disease. Range of time to progression was 0.2-20 years. Nine patients with low-grade GG progressed to a malignant tumor. The median overall survival (OS) for all patients was not reached. The 2-, 5-, and 10-year OS for patients with low-grade GG were 100%, 88% (95% confidence interval [CI]: 73%, 95%), and 84% (95% CI: 67%, 93%), respectively. Factors identified by univariate analysis that were significantly associated with OS were age, KPS, extent of resection (EOR), and grade. Factors on univariate analysis that were significantly associated with progression-free survival were grade and EOR. On multicovariate Cox regression, lower tumor grade and younger age were significant factors for longer OS. EOR is a significant factor for progression-free survival. CONCLUSIONS: While GG has excellent prognosis, malignant histologic grade, older age, and diagnosis with biopsy could indicate worse prognosis. The late nature and high rate of progression emphasize the importance of long-term follow-up. The role of chemotherapy and radiation therapy for incompletely resected low-grade GG remains unclear.
BACKGROUND:Gangliogliomas (GGs) represent <1% of primary brain tumors in adults. Little is known regarding prognostic features, clinical characteristics, or the impact of treatment on patient outcomes. METHODS: Our neuro-oncology longitudinal database was screened for patients with GG from 1992 to 2012. Sixty-seven patients (age >18 y) were identified. RESULTS: Sixty-two patients presented with low-grade GG and 5 with anaplastic GG. The median age at diagnosis was 29 years. With a median follow-up of 4.7 years after the initial diagnosis, 23 patients had progressive disease. Range of time to progression was 0.2-20 years. Nine patients with low-grade GG progressed to a malignant tumor. The median overall survival (OS) for all patients was not reached. The 2-, 5-, and 10-year OS for patients with low-grade GG were 100%, 88% (95% confidence interval [CI]: 73%, 95%), and 84% (95% CI: 67%, 93%), respectively. Factors identified by univariate analysis that were significantly associated with OS were age, KPS, extent of resection (EOR), and grade. Factors on univariate analysis that were significantly associated with progression-free survival were grade and EOR. On multicovariate Cox regression, lower tumor grade and younger age were significant factors for longer OS. EOR is a significant factor for progression-free survival. CONCLUSIONS: While GG has excellent prognosis, malignant histologic grade, older age, and diagnosis with biopsy could indicate worse prognosis. The late nature and high rate of progression emphasize the importance of long-term follow-up. The role of chemotherapy and radiation therapy for incompletely resected low-grade GG remains unclear.
Authors: J Zentner; A Hufnagel; H K Wolf; B Ostertun; E Behrens; M G Campos; C E Elger; O D Wiestler; J Schramm Journal: Neurosurgery Date: 1997-08 Impact factor: 4.654
Authors: H G Wieser; W T Blume; D Fish; E Goldensohn; A Hufnagel; D King; M R Sperling; H Lüders; T A Pedley Journal: Epilepsia Date: 2001-02 Impact factor: 5.864
Authors: Dirk Rades; Lena Zwick; Jan Leppert; Matteo M Bonsanto; Volker Tronnier; Juergen Dunst; Steven E Schild Journal: Cancer Date: 2010-01-15 Impact factor: 6.860
Authors: Julia J Compton; Nadia N Issa Laack; Laurence J Eckel; David A Schomas; Caterina Giannini; Fredric B Meyer Journal: J Neurosurg Date: 2012-09-07 Impact factor: 5.115
Authors: Joshua L Wang; Christopher S Hong; Jose Otero; Vinay K Puduvalli; J Bradley Elder Journal: World Neurosurg Date: 2016-09-23 Impact factor: 2.104
Authors: Jiri Bartek; Sanjay Dhawan; Erik Thurin; Ali Alattar; Sasha Gulati; Bertil Rydenhag; Roger Henriksson; Clark C Chen; Asgeir Store Jakola Journal: J Neurooncol Date: 2020-05-19 Impact factor: 4.130