Oligodendroglioma natural history, complications, and prognosis: Difference between revisions
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**1p19q codeletion absent = shorter overall survival | **1p19q codeletion absent = shorter overall survival | ||
*Several other molecular markers have a potential clinical significance as [[isocitrate dehydrogenase|IDH1]] mutations, confirming the strong prognostic role for overall survival. | *Several other molecular markers have a potential clinical significance as [[isocitrate dehydrogenase|IDH1]] mutations, confirming the strong prognostic role for overall survival. | ||
* | *The presence of ''[[EGFR]]'' gene mutation is associated with a worse prognosis.<ref name="pmid25943885">{{cite journal| author=Wesseling P, van den Bent M, Perry A| title=Oligodendroglioma: pathology, molecular mechanisms and markers. | journal=Acta Neuropathol | year= 2015 | volume= 129 | issue= 6 | pages= 809-27 | pmid=25943885 | doi=10.1007/s00401-015-1424-1 | pmc=PMC4436696 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25943885 }} </ref> | ||
*The 5-year survival rates for oligodendroglioma and [[anaplastic|anaplastic oligodendroglioma]] varying with ages are tabulated below:<ref name=survivalstats>Survival statistics for gliomas. Canadian Cancer Society 2015.http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/prognosis-and-survival/survival-statistics/?region=on</ref> | *The 5-year survival rates for oligodendroglioma and [[anaplastic|anaplastic oligodendroglioma]] varying with ages are tabulated below:<ref name=survivalstats>Survival statistics for gliomas. Canadian Cancer Society 2015.http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/prognosis-and-survival/survival-statistics/?region=on</ref> | ||
Revision as of 14:17, 15 October 2015
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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 oligodendroglioma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[1] Common complications associated with oligodendroglioma include hydrocephalus, intracranial hemorrhage, coma, bone marrow metastasis, recurrence, venous thromboembolism, parkinsonism, and side effects of chemotherapy and radiotherapy.[2][3][4][5][6][7][8] Depending on the extent and grade of the tumor at the time of diagnosis, the prognosis of oligodendroglioma may vary. However, the prognosis is generally regarded as good. The median survival time for oligodendroglioma is 11.6 years for grade II and 3.5 years for grade III.[9]
Natural history
- Oligodendrogliomas tend to be low grade and less aggressive than other types of gliomas. These tumors are slow growing. The tumors may be present for many years before they are diagnosed.[10]
- Anaplastic oligodendroglioma usually grow quickly. These tumors may develop in one place or in many places throughout the brain.
- If left untreated, patients with oligodendroglioma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[1]
- Recurrence is a very common feature of oligodendrogliomas. It can be either of the same grade or higher grade at the primary site.[11]
- Transformation into glioblastoma (grade 4) may occur a few years later, which may be associated with gain of chromosome 7 and loss of chromosome 10.[11]
Complications
Common complications associated with oligodendroglioma include:[2][3][4][5][6][7][8]
- Hydrocephalus
- Intracranial hemorrhage
- Coma
- Bone marrow metastasis
- Recurrence
- Venous thromboembolism
- Parkinsonism
- 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 oligodendroglioma may vary. However, the prognosis is generally regarded as good.[9]
- Oligodendrogliomas are slowly growing tumors with prolonged survival. The median survival time for oligodendroglioma is 11.6 years for grade II and 3.5 years for grade III.
- Allelic losses of chromosomes 1p and 19q occur in 50%–70% of both low-grade and anaplastic tumors, representing a strong prognostic factor and a powerful predictor of prolonged survival.[2][12]
- 1p19q codeletion present = better prognosis and greater chemosensitivity
- 1p19q codeletion absent = shorter overall survival
- Several other molecular markers have a potential clinical significance as IDH1 mutations, confirming the strong prognostic role for overall survival.
- The presence of EGFR gene mutation is associated with a worse prognosis.[13]
- The 5-year survival rates for oligodendroglioma and anaplastic oligodendroglioma varying with ages are tabulated below:[14]
| WHO grade of tumor | Age | 5-year survival rate |
|---|---|---|
| Oligodendroglioma (Grade II) | 20-44 | 82% |
| 45-54 | 67% | |
| 55-64 | 48% | |
| Anaplastic oligodendroglioma (Grade III) | 20-44 | 64% |
| 45-54 | 50% | |
| 55-64 | 23% |
References
- ↑ 1.0 1.1 Manousaki M, Papadaki H, Papavdi A, Kranioti EF, Mylonakis P, Varakis J; et al. (2011). "Sudden unexpected death from oligodendroglioma: a case report and review of the literature". Am J Forensic Med Pathol. 32 (4): 336–40. doi:10.1097/PAF.0b013e3181d3dc86. PMID 20375839.
- ↑ 2.0 2.1 2.2 Simonetti G, Gaviani P, Botturi A, Innocenti A, Lamperti E, Silvani A (2015). "Clinical management of grade III oligodendroglioma". Cancer Manag Res. 7: 213–23. doi:10.2147/CMAR.S56975. PMC 4524382. PMID 26251628.
- ↑ 3.0 3.1 Guppy KH, Akins PT, Moes GS, Prados MD (2009). "Spinal cord oligodendroglioma with 1p and 19q deletions presenting with cerebral oligodendrogliomatosis". J Neurosurg Spine. 10 (6): 557–63. doi:10.3171/2009.2.SPINE08853. PMID 19558288.
- ↑ 4.0 4.1 Sharma A, Agarwal A, Sharma MC, Anand M, Agarwal S, Raina V (2003). "Bone marrow metastasis in anaplastic oligodendroglioma". Int J Clin Pract. 57 (4): 351–2. PMID 12800473.
- ↑ 5.0 5.1 Solitare GB, Robinson F, Lamarche JB (1967). "Oligodendroglioma: recurrence following an exceptionally long postoperative symptom-free interval". Can Med Assoc J. 97 (14): 862–5. PMC 1923454. PMID 6051252.
- ↑ 6.0 6.1 Harada K, Kiya K, Matsumura S, Mori S, Uozumi T (1982). "Spontaneous intracranial hemorrhage caused by oligodendroglioma--a case report and review of the literature". Neurol Med Chir (Tokyo). 22 (1): 81–4. PMID 6176898.
- ↑ 7.0 7.1 Hentschel S, Toyota B (2003). "Intracranial malignant glioma presenting as subarachnoid hemorrhage". Can J Neurol Sci. 30 (1): 63–6. PMID 12619787.
- ↑ 8.0 8.1 Krauss JK, Paduch T, Mundinger F, Seeger W (1995). "Parkinsonism and rest tremor secondary to supratentorial tumours sparing the basal ganglia". Acta Neurochir (Wien). 133 (1–2): 22–9. PMID 8561031.
- ↑ 9.0 9.1 Ohgaki H, Kleihues P (2005). "Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas". J Neuropathol Exp Neurol. 64 (6): 479–89. PMID 15977639.
- ↑ 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
- ↑ 11.0 11.1 Kocaeli H, Yakut T, Bekar A, Taşkapilioğlu O, Tolunay S (2006). "Glioblastomatous recurrence of oligodendroglioma remote from the original site: a case report". Surg Neurol. 66 (6): 627–30, discussion 630-1. doi:10.1016/j.surneu.2006.02.049. PMID 17145331.
- ↑ Molecular Pathology of Oligodendroglioma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Oligodendroglioma
- ↑ Wesseling P, van den Bent M, Perry A (2015). "Oligodendroglioma: pathology, molecular mechanisms and markers". Acta Neuropathol. 129 (6): 809–27. doi:10.1007/s00401-015-1424-1. PMC 4436696. PMID 25943885.
- ↑ Survival statistics for gliomas. Canadian Cancer Society 2015.http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/prognosis-and-survival/survival-statistics/?region=on