Oligodendroglioma 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: Sara Mohsin, M.D.[2]Sujit Routray, M.D. [3]

Overview

If left untreated, patients with oligodendroglioma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.Common complications associated with oligodendroglioma include hydrocephalus, intracranial hemorrhage, coma, bone marrow metastasis, recurrence, venous thromboembolism, parkinsonism, and side effects of chemotherapy and radiotherapy. Oligodendroglioma is a slow growing tumor having a good prognosis overall with prolonged survival. But the prognosis of oligodendroglioma may vary depending upon various prognostic factors such as population based estimates, clinical factors, tumor grade (II versus III), mechanism of chemosensitivity, and molecular markers such as 1p/19q-codeletion, IDH1/2 mutation, and TERT promoter mutations. The median survival time for oligodendroglioma is 11.6 yearsfor grade II and 3.5 years for grade III.

Natural history

Complications

Common complications associated with oligodendroglioma include:[4][5][6][7][8][9][10]

Prognosis

Type of analysis Factors significantly associated with survival
Univariate analysis
Multivariable analysis
Estimated mean survival of patients with different oligodendroglial tumors (both low-grade and anaplastic oligodendrogliomas)[14]
Oligodendroglial tumor characteristics Mean survival
1p/19q deletion with radiation 121 months
1p/19q deletion with chemotherapy over 160 months

(mean not yet reached)

No 1p/19q deletion with radiation 58 months
No 1p/19q deletion with chemotherapy 75 months
Estimated median survival of patients with anaplastic oligodendrogliomas[15]
Anaplastic oligodendroglioma characteristics Median survival
Combined 1p/19q loss >123 months
1p loss only 71 months
1p intact with TP53 mutation 71 months
1p intact with no TP53 mutation 16 months

Prognostic factors

Following are the few prognostic factors associated with oligodendroglial tumors:

Population based estimates

Clinical factors

Following is a list of more commonly identified clinical features that predict worse overall survival:

Clinical features that are independently associated with improved overall survival in patients with anaplastic oligodendroglial tumors include:[31][32]

Tumor grade (II versus III)

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%

Molecular markers

Mechanism of chemosensitivity

References

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