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Factors influencing survival in high-grade
gliomas
Buckner JC
Mayo Clinic, Rochester, MN, USA.
Multivariate analyses have consistently identified a number of patient, tumor,
and treatment variables that are significant prognostic factors for overall
survival in patients with high-grade glioma.
Age, performance status, mental status, tumor grade and histology, and extent of
surgical resection are among the most significant prognostic factors influencing
survival.
Recently, we showed that normal versus abnormal baseline Folstein mini-mental
status examination score is a significant prognostic factor in younger patients
(age </=42), suggesting that mental status may be a more important
determinant of clinical outcome than physical functioning in patients with
high-grade glioma. [BrainLife]
Among tumor variables, tumor grade and histology appear to have the greatest
effect on survival.
A recursive partitioning analysis of three Radiation Therapy Oncology Group
trials showed that among patients under 50 years of age, astrocytoma with
anaplastic or atypical foci was associated with significantly improved survival
compared with glioblastoma.
An oligodendroglial component was also associated with improved survival in
patients with grade 3 astrocytoma.
In addition, combined loss of chromosome arms 1p and 19q is associated with
improved chemosensitivity and overall survival in patients with pure
oligodendroglioma.
Among the treatment variables tested, extent of resection appears to be the most
consistent prognostic factor.
Gross total resection is associated with significantly improved survival
compared with biopsy only.
These models are capable of grouping patients into distinct prognostic subgroups
with median survivals ranging from less than 5 to more than 50 months and thus
provide useful information for future clinical trial design.
PMID: 14765378 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14765378
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