Oligoastrocytoma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
If left untreated, patients with oligoastrocytoma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death. Oligoastrocytomas are slow growing tumors. Common complications associated with oligoastrocytoma include hydrocephalus, intracranial hemorrhage, coma, metastasis, venous thromboembolism, and side effects of chemotherapy and radiation. Depending on the extent and grade of the tumor at the time of diagnosis, the prognosis of oligoastrocytoma may vary. However, the prognosis is generally regarded as good. The prognosis of low-grade oligoastrocytoma is more favorable than that for anaplastic oligoastrocytoma because of the more indolent course and younger age at which most patients are diagnosed. The 1, 5, and 10-year survival rates of patients with oligoastrocytoma are approximately 87%, 56.97%, and 45.80%, respectively.
Natural history
- Oligoastrocytomas are slow growing tumors.[1] The tumors may be present for many years before they are diagnosed.[2]
- If left untreated, patients with oligoastrocytoma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[3][4][5]
- The mixed gliomas with a 1p/19q loss would behave in an indolent or chemo-responsive fashion as expected of an oligodendroglioma, whereas those without this profile act biologically like astrocytic tumors, i.e. more aggressively and more prone to high grade transformation.[6]
Complications
Common complications associated with oligoastrocytoma include:[4][7][8][3][9][5]
- Hydrocephalus
- Intracranial hemorrhage
- Coma
- Metastasis
- Recurrence
- Venous thromboembolism
- Side effects of chemotherapy
- Side effects of radiotherapy
Prognosis
- Depending on the extent and grade of the tumor at the time of diagnosis, the prognosis of oligoastrocytoma may vary. However, the prognosis is generally regarded as good.[10]
- The prognosis of oligoastrocytoma is more favorable than that of anaplastic oligoastrocytoma because of the more indolent course and younger age at which most patients are diagnosed.[4]
- The 1, 5, and 10-year survival rates of patients with oligoastrocytoma are approximately 87%, 56.97%, and 45.80%, respectively.[11]
- Favorable prognostic factors for oligoastrocytoma include:[12][13][7][14][15][3]
- Presence of 1p19q codeletion
- Age at presentation < 40 years
- Lower grade of tumor
- Absence of tumor necrosis
- Seizure as presenting symptom
- Presence of MGMT gene promoter hypermethylation
- Extent of surgical resection
- Good performance status
- Intact neurological function
- Presence of microvascular proliferation and necrosis are poor prognostic factors for oligoastrocytoma.[16]
References
- ↑ Adesina, Adekunle (2010). Atlas of pediatric brain tumors. New York: Springer. ISBN 9781441910622.
- ↑ Survival by prognostic factors. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/prognosis-and-survival/survival-statistics/?region=on
- ↑ 3.0 3.1 3.2 Chandana SR, Movva S, Arora M, Singh T (2008). "Primary brain tumors in adults". Am Fam Physician. 77 (10): 1423–30. PMID 18533376.
- ↑ 4.0 4.1 4.2 Grier, J. T. (2006). "Low-Grade Gliomas in Adults". The Oncologist. 11 (6): 681–693. doi:10.1634/theoncologist.11-6-681. ISSN 1083-7159.
- ↑ 5.0 5.1 Specht CS, Pinto-Lord C, Smith TW, DeGirolami U, Suran E, Marshall PC; et al. (1986). "Spontaneous hemorrhage in a mixed glioma of the cerebellum: case report". Neurosurgery. 19 (2): 278–81. PMID 3748360.
- ↑ Ersen, A. (2008), Pathology of malignant gliomas: Challenges of everyday practice and the WHO 2007, Turkish Journal of Pathology, p. 194-212, retrieved October 20, 2015
- ↑ 7.0 7.1 Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group (2010). "High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Ann Oncol. 21 Suppl 5: v190–3. doi:10.1093/annonc/mdq187. PMID 20555079.
- ↑ Signs and symptoms of glioma. Wikipedia 2015. https://en.wikipedia.org/wiki/Glioma. Accessed on October 20, 2015
- ↑ Finsterer J, Breiteneder S, Mueller MR, Wogritsch C, Vesely M, Kleinert R; et al. (1998). "Pleural and bone marrow metastasis from supratentorial oligoastrocytoma grade III". Oncology. 55 (4): 345–8. PMID 9663425.
- ↑ Liang Y, Bollen AW, Nicholas MK, Gupta N (2005). "Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas". BMC Clin Pathol. 5: 6. doi:10.1186/1472-6890-5-6. PMC 1182359. PMID 16018821.
- ↑ One–, Two–, Three–, Four–, Five–, and 10–year relative survival rates for selected malignant brain and central nervous system tumors, Seer 17 Registries, 1995-2006. CBTRUS 2015. http://www.cbtrus.org/2010-NPCR-SEER/CBTRUS-WEBREPORT-Final-3-2-10.pdf. Accessed on October 16, 2015
- ↑ Pathology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015
- ↑ Naugle DK, Duncan TD, Grice GP (2004). "Oligoastrocytoma". Radiographics. 24 (2): 598–600. doi:10.1148/rg.242035069. PMID 15026604.
- ↑ Prognosis of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015
- ↑ Pouratian N, Schiff D (2010). "Management of low-grade glioma". Curr Neurol Neurosci Rep. 10 (3): 224–31. doi:10.1007/s11910-010-0105-7. PMC 2857752. PMID 20425038.
- ↑ Miller, C. R.; Dunham, C. P.; Scheithauer, B. W.; Perry, A. (2006). "Significance of Necrosis in Grading of Oligodendroglial Neoplasms: A Clinicopathologic and Genetic Study of Newly Diagnosed High-Grade Gliomas". Journal of Clinical Oncology. 24 (34): 5419–5426. doi:10.1200/JCO.2006.08.1497. ISSN 0732-183X.