Oligodendroglioma natural history, complications, and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [3]
Overview
Natural history
- Oligodendrogliomas tend to be low grade and less aggressive than other types of gliomas.[1]
- If left untreated, patients with oligodendroglioma may progress to develop focal neurological deficits, altered mental status, hydrocephalus, brain herniation, and ultimately death.
- Recurrence is a very common feature of oligodendrogliomas. It can be either of the same grade or higher grade at the primary site.[2]
- The recurrence rate of seizures in oligodendroglioma is highest among all brain tumors.
Complications
Common complications associated with oligodendroglioma include:[3][4][5][6][7]
- Hydrocephalus
- Intracranial hemorrhage
- Coma
- Bone marrow metastasis
- Recurrence
- Side effects of chemotherapy
- Side effects of radiotherapy
Prognosis
Oligodendrogliomas are generally felt to be incurable using current treatments. However compared to the more common astrocytomas, they are slowly growing with prolonged survival. In one series, median survival times for oligodendrogliomas were 11.6 years for grade II and 3.5 years for grade III.[8]
Long-term survival is reported in a minority of patients.[9] With aggressive treatment and close monitoring, it is possible to outlive the typical life expectancies for both low grade and high grade oligodendrogliomas. In rare cases, patients have survived for up to fifteen years post-diagnosis. Westergaard’s study (1997) showed that patients younger than 20 years had a median survival of 17.5 years.[10] Another study shows a 34% survival rate after 20 years. [11]
1p/19q deletion has been correlated with both chemosensitivity and improved prognosis in oligodendrogliomas.[12][13]
A recent study showed that the presence of the 1p19q codeletion is a relevant marker of longer overall survival in patients with low grade gliomas and isocitrate dehydrogenase 1 (IDH1) mutation 3. In other words: <radiopaedia>
IDH1 positive + 1p19q codeletion = better prognosis IDH1 positive + no 1p19q codeletion = shorter overall survival
EGFR gene mutation is associated with poorer prognosis.[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
- ↑ 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
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Hentschel S, Toyota B (2003). "Intracranial malignant glioma presenting as subarachnoid hemorrhage". Can J Neurol Sci. 30 (1): 63–6. PMID 12619787.
- ↑ Ohgaki H, Kleihues P. Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol. 2005 Jun;64(6):479-89. PMID: 15977639
- ↑ Tatter SB. Recurrent malignant glioma in adults. Curr Treat Options Oncol. 2002 Dec;3(6):509-24. PMID: 12392640,
- ↑ Herbert H. Engelhard, M.D., Ph.D., Ana Stelea, M.D., and Arno Mundt, M.D.[1] p.449
- ↑ Feigenberg SJ, Amdur RJ, Morris CG, Mendenhall WM, Marcus RB, Friedman WA (2003). "Oligodendroglioma: does deferring treatment compromise outcome?". Am. J. Clin. Oncol. 26 (3): e60–6. doi:10.1097/01.COC.0000072507.25834.D6. PMID 12796617.
- ↑ Laigle-Donadey F, Benouaich-Amiel A, Hoang-Xuan K, Sanson M (2005). "[Molecular biology of oligodendroglial tumors]". Neuro-Chirurgie (in French). 51 (3-4 Pt 2): 260–8. PMID 16292170.
- ↑ Walker C, Haylock B, Husband D; et al. (2006). "Clinical use of genotype to predict chemosensitivity in oligodendroglial tumors". Neurology. 66 (11): 1661–7. doi:10.1212/01.wnl.0000218270.12495.9a. PMID 16769937.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID doi:10.1016/S0090-3019(03)00167-8 Check
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