Katja[a]
5-years follow-up in 90 patients with oligodendroglial tumors
Author(s): M. Frenay, C. Lebrun, A. Ramaioli, D. Fontaine, V. Bourg, J.-F. Michiels; Centre Antoine Lacassagne, Nice, France; Pasteur Hospital, Nice, France
Background:
Oligodendroglial tumors are chemosensitive and seems to have a better prognosis than astrocytomas. Since 1995, we collected in our neuro-oncological database 800 primary brain tumors and identified grades II and III oligodendrogliomas (OG) according to WHO classification. We analyzed data including demographic characteristics, clinical management and survival at 2 and 5 years. Design/methods: 90 patients were identified :32 grade II or low grade OG(LOG); 39 grade III or anaplastic OG (AOG); 19 grade II transformed in grade III OG (TOG). All patients were symptomatic and had neurosugical procedure for histological diagnosis. Follow-up was performed with clinical assessment and brain MRI. Results: Patients characteristics were: 59 males; 31 females; mean age at diagnosis: 46.7yrs (LOG: 46 ; AOG: 52; TOG:41). Mean age at first symptom was 46yrs; First symptom was mostly partial epileptic seizures (80%), or neurological deficit for12%. Diagnosis was performed in the first-6 months after first symptom for 63%LOG; 80% AOG and 90% TOG. Sixty patients had gadolinium enhancement (LOG:18%; AOG:89%; TOG:95%). Neurosurgical strategy was: biopsy only (41%); partial resection<90% (37%); partial resection >90% (47%); total resection (16%). After histological analysis, 42 patients (49%) had first-line chemotherapy (CT) (79% OG; 32% AOG) and brain radiotherapy (RT) as second line of treatment. 27 (31%) patients had first-line RT and CT at recurrence. Time for anaplastic transformation in TOG was 40 months with a median survival of 72 months (14 months as grade III). Survival at 2 years was LOG: 88%; AOG: 49%; TOG: 89%). After 5 years of follow-up, 23 patients are still alive. Conclusion: These data suggest that
(1) Transformed OG are younger than de novo AOG.
(2) Histological confirmation is mandatory because some LOG have gadolinium enhancement on MRI and some AOG had not.
(3) Epileptic seizure is the most common revealing symptom
(4) Overall survival seems to be better for OG and TOG than for AOG patients.
ASCO 2003, Abstract No: 435 Category: CNS Tumors