Glioma natural history, complications and prognosis: Difference between revisions

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Latest revision as of 13:29, 30 September 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Common complications of glioma include brain herniation, hydrocephalus, coma, metastasis, recurrence, side effects of chemotherapy, and side effects of radiation therapy. The prognosis of glioma varies with the grade of tumor. The 1-year and 2-year survival rate of patients with malignant glioma is approximately 50% and 25%, respectively.^[1]

Complications

Common complications of glioma include:

Prognosis

The prognosis of glioma varies with the grade of tumor: WHO grade 1 and WHO grade 4 have the most favorable and worst prognosis, respectively.
The 1-year and 2-year survival rate of patients with malignant glioma is approximately 50% and 25%, respectively.
Post-operative radiation therapy is often used as an adjunct to surgery in the treatment of high-grade gliomas as it has shown to double the median survival for high-grade gliomas to 37 weeks (versus 17 weeks with surgery alone).
The prognosis of glioma may depend on other factors which include:^[1]

Location of the tumor (brain or spinal cord)
Resectability
Primary diagnosis vs. recurrence
Specific mutations:

DNA methylation of the O6-methylguanine-DNA methyltransferase (MGMT) gene promoter
Mutation of isocitrate dehydrogenase: IDH1 or IDH2 genes
Codeletion of chromosomes 1p and 19q

References

↑ ^1.0 ^1.1 Prognostic factors of glioma. National Cancer Institute. http://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq

[eee-1] 1.0 ^1.1 Prognostic factors of glioma. National Cancer Institute. http://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq

[1]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Glioma}}
+{{CMG}}{{AE}}{{SR}}
-{{CMG}}
 ==Overview==
-The prognosis of glioma is poor.
+Common complications of glioma include [[brain herniation]], [[hydrocephalus]], [[coma]], [[metastasis]], recurrence, [[Chemotherapy|side effects of chemotherapy]], and [[Radiation|side effects of radiation therapy]]. The prognosis of glioma varies with the grade of tumor. The 1-year and 2-year survival rate of patients with [[malignant|malignant glioma]] is approximately 50% and 25%, respectively.<ref name=eee>Prognostic factors of glioma. National Cancer Institute. http://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq</ref>
-==Natural history==
 ==Complications==
+Common complications of glioma include:
+*[[Brain herniation]]
+*[[Hydrocephalus]]
+*[[Coma]]
+*[[Metastasis]]
+*Recurrence
+*[[Chemotherapy|Side effects of chemotherapy]]
+*[[Radiation|Side effects of radiation therapy]]
 ==Prognosis==
-The prognosis of glioma varies with the grade of tumor: Grade 1 and grade 4 have the most favorable and worst prognosis, respectively.
+*The prognosis of glioma varies with the grade of tumor: WHO grade 1 and WHO grade 4 have the most favorable and worst prognosis, respectively.
+*The 1-year and 2-year survival rate of patients with [[malignant|malignant glioma]] is approximately 50% and 25%, respectively.
-The prognosis for glioma depend on the following:<ref name=eee>Prognostic factors of glioma. National Cancer Institute. http://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq</ref>
+*Post-operative [[radiation therapy]] is often used as an adjunct to [[surgery]] in the treatment of high-grade gliomas as it has shown to double the median survival for high-grade gliomas to 37 weeks (versus 17 weeks with surgery alone).
-*Type and grade of the [[tumor]]
+*The prognosis of glioma may depend on other factors which include:<ref name=eee>Prognostic factors of glioma. National Cancer Institute. http://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq</ref>
-*Tumor is in the [[brain]] or [[spinal cord]]
+:*Location of the tumor ([[brain]] or [[spinal cord]])
-*Whether the tumor can be removed by [[surgery]]
+:*Resectability
-*Whether the cancer has just been diagnosed or has recurred.
+:*Primary diagnosis vs. recurrence
-*DNA [[methylation]] of the O6-methylguanine-DNA methyltransferase (''MGMT'') gene promoter.
+:*Specific mutations:
-*Mutation of [[isocitrate dehydrogenase]]: IDH1 or [[IDH2]] genes.
+::*DNA [[methylation]] of the O6-methylguanine-DNA methyltransferase (''MGMT'') gene promoter
-*Codeletion of [[chromosomes]] 1p and 19q.
+::*Mutation of [[isocitrate dehydrogenase]]: IDH1 or [[IDH2]] genes
+::*Codeletion of [[chromosomes]] 1p and 19q
-Gliomas are rarely curable.
-The prognosis for patients with high-grade gliomas is generally poor, and is especially so for older patients. Of 10,000 Americans diagnosed each year with malignant gliomas, about half are alive one year after diagnosis, and 25% after two years.
-Those with anaplastic [[astrocytoma]] survive about three years.
-[[Glioblastoma multiforme]] has a worse prognosis with less than a 12-month average survival after diagnosis, though this has extended to 14 months with more recent treatments.<ref>{{cite news |author=Rob Stein |title=Malignant Gliomas Affect About 10,000 Americans Annually |url=http://www.washingtonpost.com/wp-dyn/content/article/2008/05/20/AR2008052001376.html |publisher=Washington Post |date=May 20, 2008 }}</ref>
 ==References==
 {{reflist|2}}