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Prognostic Factors for Survival in
Adult Patients With Cerebral Low-Grade Glioma
Francesco Pignatti, Martin
van den Bent, Desmond Curran, Channa
Debruyne, Richard Sylvester, Patrick
Therasse, Denes Áfra, Philippe Cornu,
Michel Bolla, Charles Vecht, Abul
B.M.F. Karim for the European Organization for Research and
Treatment of Cancer Brain Tumor Cooperative Group and Radiotherapy
Cooperative Group
From the European Organization for
Research and Treatment of Cancer Data Center, Brussels, Belgium;
University Hospital Rotterdam–Daniel Den Hoed Kliniek, Rotterdam;
Westeinde Ziekenhuis, Den Haag; and Vrije Universiteit Hospital,
Amsterdam, the Netherlands; National Institute of Neurosurgery,
Budapest, Hungary; Centre Hospitalier Universitaire Pitié-Salpêtrière,
Paris; and Centre Hospitalier Régional de Grenoble–La Tronche,
Grenoble, France.
Address reprint requests to Francesco Pignatti, MD, MSc, European
Agency for the Evaluation of Medicinal Products, 7 Westferry Circus,
Canary Wharf, London E14 4HB, United Kingdom; email: francesco
mailto:.pignatti@emea.eu.int . Submitted January 24, 2001; accepted
January 21, 2002.
Purpose. To identify
prognostic factors for survival in adult patients with
cerebral low-grade glioma (LGG), to derive a prognostic scoring
system, and to validate results using an independent data
set.
Patients and Methods.
European Organization for Research and Treatment of Cancer
(EORTC) trial 22844 and EORTC trial 22845 are the largest
phase III trials ever carried out in adult patients with
LGG.
The trials were designed to investigate the dosage and
timing of postoperative radiotherapy in LGG.
Cox analysis was performed on 322 patients from EORTC trial
22844 (construction set), and the results were validated on
288 patients from trial 22845 (validation set).
Patients with pilocytic astrocytomas were excluded from
this prognostic factor analysis.
Results. Multivariate
analysis on the construction set showed that age 
40 years, astrocytoma histology subtype, largest diameter of
the tumor
6 cm, tumor crossing the midline, and presence of
neurologic deficit before surgery were unfavorable prognostic factors
for survival.
The total number of unfavorable factors present can be used
to determine the prognostic score.
Presence of up to two of these factors identifies the
low-risk group, whereas a higher score identifies high-risk
patients.
The validity of the multivariate model and of the scoring
system was confirmed in the validation set.
Conclusion. In adult
patients with LGG, older age, astrocytoma histology,
presence of neurologic deficits before surgery, largest tumor
diameter, and tumor crossing the midline were important prognostic
factors for survival.
These factors can be used to identify low-risk and
high-risk patients.
© 2002 American Society for
Clinical Oncology
Source: http://www.jco.org/cgi/content/abstract/20/8/2076
HTML Full Text: http://www.jco.org/cgi/content/full/20/8/2076
PDF Full Text: http://www.jco.org/cgi/reprint/20/8/2076
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