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Staging and Prognosis
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> Antiangiogenesis
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40th
ASCO Annual Meeting. New Orleans, LA. June 5-8, 2004. Abstract No.1545 (Clinical
Study)
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Meeting Abstract |
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Baseline pathological
and radiological assessment of tumor angiogenesis predicts survival in patients
with oligodendrogliomas
B. S. Abdulkarim, A. Hasbini, J. Cougnard, L. Djafari, C. Lacroix, F. Parker,
C. Haie, C. Cioloca, E. Deutsch, E. Raymond
IGR, Villejuif, France; Shering-Plough, Levalois-Perret, France;
Hopital Kremlin Bicetre, Kremlin Bicetre, France; Hopital Ste Anne, Paris,
France
Background. Malignant transformation of
oligodendrogliomas (ODG) is associated with increased angiogenesis (endothelial
hyperplasia, vascular proliferation of leaking vessels and tumor necrosis). Our
aim was to evaluate the prognostic value of tumor angiogenesis assessed by
pathological and radiological examinations on progression-free (PFS) and overall
survival (OS) in patient (pts) with ODG.
Methods. All pts with ODG consecutively
treated in our Institution from 1994-2000.
Pathological sections were re-evaluated to confirm the diagnosis of ODs and to
assess the degree of nuclear atypia, mitosis, endothelial hyperplasia, and
necrosis.
CT-scan and/or MRI images were re-analyzed to assess contrast enhancement and
necrosis.
A multivariate analysis was performed including baseline demographic data,
histological and radiological factors associated with tumor angiogenesis and
treatment.
Results. 134 pts with histologically
confirmed low grade (WHO grade II, n=49) and anaplastic ODG (WHO grade III,
n=85) were analyzed.
Univariate analysis showed that prognostic factors associated with better PFS
and OS were age <55 (p<0.0001), ODG revealed by seizure (p<0.0001),
lack of endothelial hyperplasia (p<0.001), lack of contrast
enhancement (p=0.02), and lack of histological/radiological evidence of
tumor necrosis (p<0.0001).
Multivariate analysis identified necrosis, endothelial hyperplasia and/or
contrast enhancement, age, and seizures as independent bad-prognostic factors
for OS.
This enabled us to defined three pts groups (low, intermediate, and high risk
ODG) according to NEVA score using the more robust parameters (necrosis,
epilepsy, vessel and age).
Conclusion. Endothelial hyperplasia,
contrast enhancement, and necrosis that reflect a mutli-step development of
tumor angiogenesis are independent factors of bad prognosis in pts with ODG.
Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0026-00_19-002702,00.asp
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