Oligoastrocytoma natural history, complications and prognosis: Difference between revisions

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{{Oligodendroglioma}}
{{Oligoastrocytoma}}
{{CMG}}{{AE}}{{SR}}
{{CMG}}{{AE}}{{SR}}


==Overview==
==Overview==
If left untreated, patients with oligodendroglioma may progress to develop [[seizures]], focal neurological deficits, [[hydrocephalus]], [[brain herniation]], [[intracranial hemorrhage]], and ultimately death.<ref name="pmid20375839">{{cite journal| author=Manousaki M, Papadaki H, Papavdi A, Kranioti EF, Mylonakis P, Varakis J et al.| title=Sudden unexpected death from oligodendroglioma: a case report and review of the literature. | journal=Am J Forensic Med Pathol | year= 2011 | volume= 32 | issue= 4 | pages= 336-40 | pmid=20375839 | doi=10.1097/PAF.0b013e3181d3dc86 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20375839  }} </ref> Common complications associated with oligodendroglioma include [[hydrocephalus]], [[intracranial hemorrhage]], [[coma]], [[metastasis|bone marrow metastasis]], recurrence, [[venous thromboembolism]], [[parkinsonism]], and side effects of [[chemotherapy]] and [[radiotherapy]].<ref name="pmid26251628">{{cite journal| author=Simonetti G, Gaviani P, Botturi A, Innocenti A, Lamperti E, Silvani A| title=Clinical management of grade III oligodendroglioma. | journal=Cancer Manag Res | year= 2015 | volume= 7 | issue=  | pages= 213-23 | pmid=26251628 | doi=10.2147/CMAR.S56975 | pmc=PMC4524382 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26251628  }} </ref><ref name="pmid19558288">{{cite journal| author=Guppy KH, Akins PT, Moes GS, Prados MD| title=Spinal cord oligodendroglioma with 1p and 19q deletions presenting with cerebral oligodendrogliomatosis. | journal=J Neurosurg Spine | year= 2009 | volume= 10 | issue= 6 | pages= 557-63 | pmid=19558288 | doi=10.3171/2009.2.SPINE08853 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19558288  }} </ref><ref name="pmid12800473">{{cite journal| author=Sharma A, Agarwal A, Sharma MC, Anand M, Agarwal S, Raina V| title=Bone marrow metastasis in anaplastic oligodendroglioma. | journal=Int J Clin Pract | year= 2003 | volume= 57 | issue= 4 | pages= 351-2 | pmid=12800473 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12800473  }} </ref><ref name="pmid6051252">{{cite journal| author=Solitare GB, Robinson F, Lamarche JB| title=Oligodendroglioma: recurrence following an exceptionally long postoperative symptom-free interval. | journal=Can Med Assoc J | year= 1967 | volume= 97 | issue= 14 | pages= 862-5 | pmid=6051252 | doi= | pmc=PMC1923454 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6051252  }} </ref><ref name="pmid6176898">{{cite journal| author=Harada K, Kiya K, Matsumura S, Mori S, Uozumi T| title=Spontaneous intracranial hemorrhage caused by oligodendroglioma--a case report and review of the literature. | journal=Neurol Med Chir (Tokyo) | year= 1982 | volume= 22 | issue= 1 | pages= 81-4 | pmid=6176898 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6176898  }} </ref><ref name="pmid12619787">{{cite journal| author=Hentschel S, Toyota B| title=Intracranial malignant glioma presenting as subarachnoid hemorrhage. | journal=Can J Neurol Sci | year= 2003 | volume= 30 | issue= 1 | pages= 63-6 | pmid=12619787 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12619787  }} </ref><ref name="pmid8561031">{{cite journal| author=Krauss JK, Paduch T, Mundinger F, Seeger W| title=Parkinsonism and rest tremor secondary to supratentorial tumours sparing the basal ganglia. | journal=Acta Neurochir (Wien) | year= 1995 | volume= 133 | issue= 1-2 | pages= 22-9 | pmid=8561031 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8561031  }} </ref> 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.<ref name="pmid15977639">{{cite journal| author=Ohgaki H, Kleihues P| title=Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. | journal=J Neuropathol Exp Neurol | year= 2005 | volume= 64 | issue= 6 | pages= 479-89 | pmid=15977639 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15977639  }} </ref>
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==
==Natural history==
*Oligodendrogliomas tend to be low grade and less aggressive than other types of [[glioma]]s. These tumors are slow growing. The tumors may be present for many years before they are diagnosed.<ref name=surv>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</ref>
*Oligoastrocytomas are slow growing tumors.<ref name="pathoOA1">{{cite book | last = Adesina | first = Adekunle | title = Atlas of pediatric brain tumors | publisher = Springer | location = New York | year = 2010 | isbn = 9781441910622 }}</ref> The tumors may be present for many years before they are diagnosed.<ref name="surv">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</ref>
*[[Anaplastic|Anaplastic oligodendroglioma]] usually grows quickly. These tumors may develop in one place or in many places throughout the brain.
*If left untreated, patients with oligoastrocytoma may progress to develop [[seizures]], focal neurological deficits, [[hydrocephalus]], [[brain herniation]], [[intracranial hemorrhage]], and ultimately death.<ref name="pmid18533376">{{cite journal| author=Chandana SR, Movva S, Arora M, Singh T| title=Primary brain tumors in adults. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 10 | pages= 1423-30 | pmid=18533376 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18533376 }} </ref><ref name="Grier2006">{{cite journal|last1=Grier|first1=J. T.|title=Low-Grade Gliomas in Adults|journal=The Oncologist|volume=11|issue=6|year=2006|pages=681–693|issn=1083-7159|doi=10.1634/theoncologist.11-6-681}}</ref><ref name="pmid3748360">{{cite journal| author=Specht CS, Pinto-Lord C, Smith TW, DeGirolami U, Suran E, Marshall PC et al.| title=Spontaneous hemorrhage in a mixed glioma of the cerebellum: case report. | journal=Neurosurgery | year= 1986 | volume= 19 | issue= 2 | pages= 278-81 | pmid=3748360 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3748360 }} </ref>
*If left untreated, patients with oligodendroglioma may progress to develop [[seizures]], focal neurological deficits, [[hydrocephalus]], [[brain herniation]], [[intracranial hemorrhage]], and ultimately death.<ref name="pmid20375839">{{cite journal| author=Manousaki M, Papadaki H, Papavdi A, Kranioti EF, Mylonakis P, Varakis J et al.| title=Sudden unexpected death from oligodendroglioma: a case report and review of the literature. | journal=Am J Forensic Med Pathol | year= 2011 | volume= 32 | issue= 4 | pages= 336-40 | pmid=20375839 | doi=10.1097/PAF.0b013e3181d3dc86 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20375839 }} </ref>
*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.<ref name="OAnatho1">{{Citation |last=Ersen |first=A. |year=2008 |title=Pathology of malignant gliomas: Challenges of everyday practice and the WHO 2007 |publisher=Turkish Journal of Pathology |publication-place= |page= 194-212 |url=http://www.turkjpath.org/text.php3?id=645#r75 |accessdate=October 20, 2015 }}</ref>
*Recurrence is a very common feature of oligodendrogliomas. It can be either of the same grade or higher grade at the primary site.<ref name="pmid17145331">{{cite journal| author=Kocaeli H, Yakut T, Bekar A, Taşkapilioğlu O, Tolunay S| title=Glioblastomatous recurrence of oligodendroglioma remote from the original site: a case report. | journal=Surg Neurol | year= 2006 | volume= 66 | issue= 6 | pages= 627-30; discussion 630-1 | pmid=17145331 | doi=10.1016/j.surneu.2006.02.049 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17145331 }} </ref>
*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]].<ref name="pmid17145331">{{cite journal| author=Kocaeli H, Yakut T, Bekar A, Taşkapilioğlu O, Tolunay S| title=Glioblastomatous recurrence of oligodendroglioma remote from the original site: a case report. | journal=Surg Neurol | year= 2006 | volume= 66 | issue= 6 | pages= 627-30; discussion 630-1 | pmid=17145331 | doi=10.1016/j.surneu.2006.02.049 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17145331  }} </ref>


==Complications==
==Complications==
Common complications associated with oligoastrocytoma include:<ref name="pmid20555079">{{cite journal| author=Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group| title=High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2010 | volume= 21 Suppl 5 | issue=  | pages= v190-3 | pmid=20555079 | doi=10.1093/annonc/mdq187 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20555079  }} </ref>
Common complications associated with oligoastrocytoma include:<ref name="Grier2006">{{cite journal|last1=Grier|first1=J. T.|title=Low-Grade Gliomas in Adults|journal=The Oncologist|volume=11|issue=6|year=2006|pages=681–693|issn=1083-7159|doi=10.1634/theoncologist.11-6-681}}</ref><ref name="pmid20555079">{{cite journal| author=Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group| title=High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2010 | volume= 21 Suppl 5 | issue=  | pages= v190-3 | pmid=20555079 | doi=10.1093/annonc/mdq187 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20555079 }} </ref><ref name="wikiglioss1">Signs and symptoms of glioma. Wikipedia 2015. https://en.wikipedia.org/wiki/Glioma. Accessed on October 20, 2015</ref><ref name="pmid18533376">{{cite journal| author=Chandana SR, Movva S, Arora M, Singh T| title=Primary brain tumors in adults. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 10 | pages= 1423-30 | pmid=18533376 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18533376  }} </ref><ref name="pmid9663425">{{cite journal| author=Finsterer J, Breiteneder S, Mueller MR, Wogritsch C, Vesely M, Kleinert R et al.| title=Pleural and bone marrow metastasis from supratentorial oligoastrocytoma grade III. | journal=Oncology | year= 1998 | volume= 55 | issue= 4 | pages= 345-8 | pmid=9663425 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9663425  }} </ref><ref name="pmid3748360">{{cite journal| author=Specht CS, Pinto-Lord C, Smith TW, DeGirolami U, Suran E, Marshall PC et al.| title=Spontaneous hemorrhage in a mixed glioma of the cerebellum: case report. | journal=Neurosurgery | year= 1986 | volume= 19 | issue= 2 | pages= 278-81 | pmid=3748360 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3748360 }} </ref>
*[[Hydrocephalus]]
*[[Hydrocephalus]]
*[[Intracranial hemorrhage]]
*[[Intracranial hemorrhage]]
*[[Coma]]
*[[Coma]]
*[[metastasis|Bone marrow metastasis]]
*[[Metastasis]]
*Recurrence
*Recurrence
*[[Venous thromboembolism]]
*[[Venous thromboembolism]]
*[[Parkinsonism]]
*[[chemotherapy|Side effects of chemotherapy]]
*[[chemotherapy|Side effects of chemotherapy]]
*[[radiotherapy|Side effects of radiotherapy]]
*[[radiotherapy|Side effects of radiotherapy]]


==Prognosis==
==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.
*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.<ref name="pmid16018821">{{cite journal| author=Liang Y, Bollen AW, Nicholas MK, Gupta N| title=Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas. | journal=BMC Clin Pathol | year= 2005 | volume= 5 | issue=  | pages= 6 | pmid=16018821 | doi=10.1186/1472-6890-5-6 | pmc=PMC1182359 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16018821  }} </ref>
*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.
*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.<ref name="Grier2006">{{cite journal|last1=Grier|first1=J. T.|title=Low-Grade Gliomas in Adults|journal=The Oncologist|volume=11|issue=6|year=2006|pages=681–693|issn=1083-7159|doi=10.1634/theoncologist.11-6-681}}</ref>
*The 1, 5, and 10-year survival rates of patients with oligoastrocytoma are approximately 87%, 56.97%, and 45.80%.<ref name=cbtrus3> 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</ref>
*The 1, 5, and 10-year survival rates of patients with oligoastrocytoma are approximately 87%, 56.97%, and 45.80%, respectively.<ref name="cbtrus3"> 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</ref>
*Favorable prognostic factors for oligoastrocytoma include:<ref name=patho1>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</ref><ref name="pmid15026604">{{cite journal| author=Naugle DK, Duncan TD, Grice GP| title=Oligoastrocytoma. | journal=Radiographics | year= 2004 | volume= 24 | issue= 2 | pages= 598-600 | pmid=15026604 | doi=10.1148/rg.242035069 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15026604  }} </ref>
*Favorable prognostic factors for oligoastrocytoma include:<ref name="patho1">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</ref><ref name="pmid15026604">{{cite journal| author=Naugle DK, Duncan TD, Grice GP| title=Oligoastrocytoma. | journal=Radiographics | year= 2004 | volume= 24 | issue= 2 | pages= 598-600 | pmid=15026604 | doi=10.1148/rg.242035069 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15026604 }} </ref><ref name="pmid20555079">{{cite journal| author=Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group| title=High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2010 | volume= 21 Suppl 5 | issue=  | pages= v190-3 | pmid=20555079 | doi=10.1093/annonc/mdq187 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20555079  }} </ref><ref name="OAsymp4">Prognosis of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015</ref><ref name="pmid20425038">{{cite journal| author=Pouratian N, Schiff D| title=Management of low-grade glioma. | journal=Curr Neurol Neurosci Rep | year= 2010 | volume= 10 | issue= 3 | pages= 224-31 | pmid=20425038 | doi=10.1007/s11910-010-0105-7 | pmc=PMC2857752 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20425038  }} </ref><ref name="pmid18533376">{{cite journal| author=Chandana SR, Movva S, Arora M, Singh T| title=Primary brain tumors in adults. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 10 | pages= 1423-30 | pmid=18533376 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18533376 }} </ref>
:*Presence of [[translocation|1p19q codeletion]]
:*Presence of [[translocation|1p19q codeletion]]
:*Age at presentation < 40 years
:*Age at presentation < 40 years
:*Lower grade of [[tumor]]
:*Lower grade of [[tumor]]
:*Absence of tumor [[necrosis]]
:*[[Seizure]] as presenting symptom
:*Presence of ''[[Ogt|MGMT]]'' gene promoter hypermethylation
:*Extent of [[surgery|surgical resection]]
:*Extent of [[surgery|surgical resection]]
:*Good performance status
:*Intact neurological function
*Presence of microvascular proliferation and [[necrosis]] are poor prognostic factors for oligoastrocytoma.<ref name="MillerDunham2006">{{cite journal|last1=Miller|first1=C. R.|last2=Dunham|first2=C. P.|last3=Scheithauer|first3=B. W.|last4=Perry|first4=A.|title=Significance of Necrosis in Grading of Oligodendroglial Neoplasms: A Clinicopathologic and Genetic Study of Newly Diagnosed High-Grade Gliomas|journal=Journal of Clinical Oncology|volume=24|issue=34|year=2006|pages=5419–5426|issn=0732-183X|doi=10.1200/JCO.2006.08.1497}}</ref>


==References==
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Latest revision as of 03:03, 23 October 2019

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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]

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 microvascular proliferation and necrosis are poor prognostic factors for oligoastrocytoma.[16]

References

  1. ↑ Adesina, Adekunle (2010). Atlas of pediatric brain tumors. New York: Springer. ISBN 9781441910622.
  2. ↑ 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. ↑ 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. ↑ 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. ↑ 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.
  6. ↑ 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. ↑ 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.
  8. ↑ Signs and symptoms of glioma. Wikipedia 2015. https://en.wikipedia.org/wiki/Glioma. Accessed on October 20, 2015
  9. ↑ 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.
  10. ↑ 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.
  11. ↑ 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
  12. ↑ 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
  13. ↑ Naugle DK, Duncan TD, Grice GP (2004). "Oligoastrocytoma". Radiographics. 24 (2): 598–600. doi:10.1148/rg.242035069. PMID 15026604.
  14. ↑ Prognosis of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015
  15. ↑ 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.
  16. ↑ 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.


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