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Prognostic factors for low-grade gliomas
Stupp R, Janzer RC, Hegi ME, Villemure JG, Mirimanoff RO.
Multidisciplinary Oncology Center, University Hospital (CHUV),
46, Rue du Bugnon, CH-1011 Lausanne, Switzerland.
Low-grade gliomas are a heterogenous group of diseases characterized by
relatively slow-growing primary brain tumors of astrocytic and/or
oligodendroglial origin.
Many patients present with easily controlled seizures and remain stable for
years, whereas others progress rapidly to higher-grade tumors.
Several studies have retrospectively investigated tumor-, patient-, and
treatment-related prognostic factors in this patient population.
Tumor histology, grade, location, contrast enhancement, and molecular markers
have been identified as prognostic factors for survival.
Likewise, patient age, performance status, and seizure history are
patient-dependent prognostic factors.
However, although patients who undergo surgical resection and receive adjuvant
radiotherapy tend to have improved survival, treatment-dependent prognostic
factors have yet to be definitively identified.
Recursive partitioning and multivariant analyses have identified a class of
patients with good prognosis.
Younger patients with good performance status, non-contrast-enhancing tumors
(<5 cm), and tumors of oligodendroglial or mixed-oligoastrocytic subtype have
improved survival.
The European Organisation for Research and Treatment of Cancer has recently
developed a prognostic score based on identified prognostic factors to assist in
the management of low-grade gliomas.
For patients with a favorable (low-risk) score, treatment with radiotherapy or
chemotherapy treatment should be withheld until tumor progression.
For patients with a high-risk score, treatment at diagnosis may be
indicated.
However, other than surgery, the optimal types and sequence of therapies are not
yet established.
Improvements in defining prognostic factors will assist in low-grade glioma
management.
PMID: 14765381 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14765381
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