Oligodendroglioma natural history, complications, and prognosis: Difference between revisions

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{{Oligodendroglioma}}
{{Oligodendroglioma}}
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==Overview==
==Overview==
If left untreated, [[patients]] with [[oligodendroglioma]] may progress to [[Development|develop]] [[seizures]], focal [[neurological]] deficits, [[hydrocephalus]], [[brain herniation]], [[intracranial hemorrhage]], and ultimately [[Death Cap|death]].Common [[complications]] [[Association (statistics)|associated]] with [[oligodendroglioma]] include [[hydrocephalus]], [[intracranial hemorrhage]], [[coma]], [[Metastasis|bone marrow metastasis]], [[Recurrence plot|recurrence]], [[venous thromboembolism]], [[parkinsonism]], and [[side effects]] of [[chemotherapy]] and [[radiotherapy]]. [[Oligodendroglioma]] is a [[slow]] [[Growth|growing]] [[tumor]] having a good [[prognosis]] overall with prolonged [[Survival function|survival]]. But the [[prognosis]] of [[oligodendroglioma]] may vary depending upon various [[prognostic]] factors such as [[population]] based [[Estimate|estimates]], [[clinical]] factors, [[tumor]] grade (II versus III), [[Mechanism (biology)|mechanism]] of chemosensitivity, and [[Molecular marker|molecular markers]] such as [[1p36 deletion syndrome|1p]]/19q-codeletion, [[IDH1]]/[[IDH2|2]] [[mutation]], and [[TERT]] [[promoter]] [[mutations]]. The [[median]] [[Survival analysis|survival]] [[Time series|time]] for [[oligodendroglioma]] is 11.6 [[Year|years]]<nowiki/>for [[Grading (tumors)|grade]] II and 3.5 [[Year|years]] for [[Grading (tumors)|grade]] III.


==Natural history==
==Natural history==
*[[Oligodendrogliomas]] tend to be low [[Grading (tumors)|grade]] and less aggressive than other types of [[glioma]]s.
*These [[tumors]] are [[slow]] [[Growth|growing.]]
*The [[tumors]] may be present for many [[Year|years]] before they are [[Diagnose|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 [[Growth|grows]] quickly.
*These [[tumors]] may [[Development|develop]] in one [[Place cell|place]] or in many [[Place cell|places]] throughout the [[brain]].
*If left untreated, [[patients]] with [[oligodendroglioma]] may progress to [[Development|develop]] [[seizures]], focal [[neurological]] deficits, [[hydrocephalus]], [[brain herniation]], [[intracranial hemorrhage]], and ultimately [[Death Cap|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>
*[[Recurrence plot|Recurrence]] is a very common [[Features (pattern recognition)|feature]] of [[oligodendrogliomas]].
*[[Recurrence plot|Recurrence]] can be either of the same [[Grading (tumors)|grade]] or higher [[Grading (tumors)|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]] ([[Grading (tumors)|grade]] 4) may occur a few [[Year|years]] later, which may be [[Association (statistics)|associated]] with [[gain]] of [[chromosome 7]] and [[Loss function|loss]] of [[chromosome 10|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]] [[Association (statistics)|associated]] with [[oligodendroglioma]] include:<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>
*[[Hydrocephalus]]
*[[Intracranial hemorrhage]]
*[[Coma]]
*[[metastasis|Bone marrow metastasis]]
*[[Recurrence plot|Recurrence]]
*[[Venous thromboembolism]]
*[[Parkinsonism]]
*[[chemotherapy|Side effects of chemotherapy]]
*[[radiotherapy|Side effects of radiotherapy]]


==Prognosis==
==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.<ref> Ohgaki H, Kleihues P. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15977639&query_hl=10&itool=pubmed_docsum 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</ref>  
*[[Dependent variable|Depending]] on the [[Extent of reaction|extent]] and [[Grading (tumors)|grade]] of the [[tumor]] at the [[Time series|time]] of [[diagnosis]], the [[prognosis]] of [[oligodendroglioma]] may vary.
*However, the [[prognosis]] is generally regarded as good overall.<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><ref name="pmid21088844">{{cite journal| author=Hartmann C, Hentschel B, Wick W, Capper D, Felsberg J, Simon M et al.| title=Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas. | journal=Acta Neuropathol | year= 2010 | volume= 120 | issue= 6 | pages= 707-18 | pmid=21088844 | doi=10.1007/s00401-010-0781-z | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21088844  }} </ref>
*[[Oligodendrogliomas]] are [[Slow|slowly]] [[Growth|growing]] [[tumors]] with prolonged [[Survival analysis|survival]].
*In March 2001, 7 [[Neuropathologist|neuropathologists]] and 6 [[Surgery|surgical]] [[pathologists]] experienced in [[brain tumor]]-[[diagnosis]] [[Assessment and Plan|assessed]] 124 [[Oligodendroglial tumor|oligodendroglial tumors]] [[Operation (mathematics)|operated]] at the [[Mayo Clinic]] during the [[period]] of 1960 to 1990. In this [[Study design|study]], the [[prognostic]] [[Value (mathematics)|value]] of [[Histological grade|histological grading]] of [[Oligodendroglial tumor|oligodendroglial tumors]] in [[tumor]] [[Grading (tumors)|grading]] was [[Assessment and Plan|assessed]], and following [[Parameter|parameters]] of [[Significant figures|significant]] [[Association (statistics)|association]] with [[Survival analysis|survival]] was found:<ref name="pmid11245209">{{cite journal| author=Giannini C, Scheithauer BW, Weaver AL, Burger PC, Kros JM, Mork S et al.| title=Oligodendrogliomas: reproducibility and prognostic value of histologic diagnosis and grading. | journal=J Neuropathol Exp Neurol | year= 2001 | volume= 60 | issue= 3 | pages= 248-62 | pmid=11245209 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11245209  }} </ref>
{| class="wikitable"
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Type of analysis }}
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Factors significantly associated with survival}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |'''[[Univariate]] [[analysis]]'''
|
*[[Age]]
*High [[Cellular|cellularity]]
*Presence of [[mitoses]]
*[[Endothelial]] [[hypertrophy]]
*[[Proliferation]] and [[necrosis]]
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |'''[[Multivariable calculus|Multivariable]] [[analysis]]'''
|
* [[Age]]
* Presence of [[endothelial]] [[proliferation]]
|}
{| class="wikitable"
|+Estimated mean survival of patients with different oligodendroglial tumors (both low-grade and anaplastic oligodendrogliomas)<ref name="pmid16398465">{{cite journal| author=Hamlat A, Saikali S, Chaperon J, Le Calve M, Gedouin D, Ben-Hassel M et al.| title=Oligodendroglioma: clinical study and survival analysis correlated with chromosomal anomalies. | journal=Neurosurg Focus | year= 2005 | volume= 19 | issue= 5 | pages= E15 | pmid=16398465 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16398465  }} </ref>
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Oligodendroglial tumor characteristics }}
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Mean survival}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[1p36 deletion syndrome|1p]]/19q [[deletion]] with [[radiation]]
|121 months
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[1p36 deletion syndrome|1p]]/19q [[Deletion (genetics)|deletion]] with [[chemotherapy]]
|over 160 months
([[mean]] not yet [[Reachback|reached]])
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |No [[1p36 deletion syndrome|1p]]/19q [[Deletion (genetics)|deletion]] with [[radiation]]
|58 months
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |No [[1p36 deletion syndrome|1p]]/19q [[Deletion (genetics)|deletion]] with [[chemotherapy]]
|75 months
|}
{| class="wikitable"
|+Estimated median survival of patients with anaplastic oligodendrogliomas<ref name="pmid11309331">{{cite journal| author=Ino Y, Betensky RA, Zlatescu MC, Sasaki H, Macdonald DR, Stemmer-Rachamimov AO et al.| title=Molecular subtypes of anaplastic oligodendroglioma: implications for patient management at diagnosis. | journal=Clin Cancer Res | year= 2001 | volume= 7 | issue= 4 | pages= 839-45 | pmid=11309331 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11309331  }} </ref>
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Anaplastic oligodendroglioma characteristics}}
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Median survival}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Combined [[1p36 deletion syndrome|1p]]/19q [[Loss function|loss]]
|>123 months
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[1p36 deletion syndrome|1p]] [[Loss function|loss]] only
|71 months
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[1p36 deletion syndrome|1p]] intact with [[TP53]] [[mutation]]
|71 months
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[1p36 deletion syndrome|1p]] intact with no [[TP53]] [[mutation]]
|16 months
|}


Long-term survival is reported in a minority of patients.<ref>Tatter SB. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12392640&query_hl=7&itool=pubmed_DocSum Recurrent malignant glioma in adults.] ''Curr Treat Options Oncol''. 2002 Dec;'''3'''(6):509-24. PMID: 12392640,</ref> 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
===Prognostic factors===
study (1997) showed that patients younger than 20 years had a median survival of 17.5 years.<ref>Herbert H. Engelhard, M.D., Ph.D., Ana Stelea, M.D., and Arno Mundt, M.D.[http://www.virtualtrials.com/pdf/oligo.pdf] p.449</ref> Another study shows a 34% survival rate after 20 years. <ref> {{cite journal |author=Feigenberg SJ, Amdur RJ, Morris CG, Mendenhall WM, Marcus RB, Friedman WA |title=Oligodendroglioma: does deferring treatment compromise outcome? |journal=Am. J. Clin. Oncol. |volume=26 |issue=3 |pages=e60-6 |year=2003 |pmid=12796617 |doi=10.1097/01.COC.0000072507.25834.D6}}</ref>
Following are the few [[prognostic]] factors [[Association (statistics)|associated]] with [[Oligodendroglial tumor|oligodendroglial tumors]]:
====Population based estimates====
*According to the [[population]] based [[Estimate|estimates]], despite of the prolonged [[clinical]] [[Course (medicine)|course]] of [[Oligodendroglial tumor|oligodendroglial tumors]], [[outcome]] is almost always [[fatal]].
*Overall [[median]] [[Survival analysis|survival]] for [[patients]] with low-[[Grading (tumors)|grade]] [[oligodendroglioma]] is approximately 10 to 15 [[Year|years.]]<ref name="pmid29117289">{{cite journal| author=Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C et al.| title=CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014. | journal=Neuro Oncol | year= 2017 | volume= 19 | issue= suppl_5 | pages= v1-v88 | pmid=29117289 | doi=10.1093/neuonc/nox158 | pmc=5693142 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29117289  }} </ref><ref name="pmid21636710">{{cite journal| author=Lassman AB, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF et al.| title=International retrospective study of over 1000 adults with anaplastic oligodendroglial tumors. | journal=Neuro Oncol | year= 2011 | volume= 13 | issue= 6 | pages= 649-59 | pmid=21636710 | doi=10.1093/neuonc/nor040 | pmc=3107101 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21636710  }} </ref>
*[[Median]] [[Survival analysis|survival]] for [[patients]] with [[anaplastic]] [[oligodendroglioma]] is approximately 5 to 9 [[Year|years.]]<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=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15977639  }} </ref>
*[[Median]] [[Survival analysis|survival]] of [[patients]] with [[1p36 deletion syndrome|1p]]/19q-codeleted [[oligodendrogliomas]] who are [[Treatments|treated]] with [[radiation]] plus [[procarbazine]], [[Lomustine|lomustine,]] and [[vincristine]] ([[PCV regimen|PCV]]) may be closer to 20 [[Year|years]] for [[Grading (tumors)|grade]] II [[tumors]] and 15 [[Year|years]] for [[Grading (tumors)|grade]] III [[tumors|tumors.]]<ref name="pmid27050206">{{cite journal| author=Buckner JC, Shaw EG, Pugh SL, Chakravarti A, Gilbert MR, Barger GR et al.| title=Radiation plus Procarbazine, CCNU, and Vincristine in Low-Grade Glioma. | journal=N Engl J Med | year= 2016 | volume= 374 | issue= 14 | pages= 1344-55 | pmid=27050206 | doi=10.1056/NEJMoa1500925 | pmc=5170873 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27050206  }} </ref><ref name="pmid23071237">{{cite journal| author=van den Bent MJ, Brandes AA, Taphoorn MJ, Kros JM, Kouwenhoven MC, Delattre JY et al.| title=Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951. | journal=J Clin Oncol | year= 2013 | volume= 31 | issue= 3 | pages= 344-50 | pmid=23071237 | doi=10.1200/JCO.2012.43.2229 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23071237  }} </ref><ref name="pmid23071247">{{cite journal| author=Cairncross G, Wang M, Shaw E, Jenkins R, Brachman D, Buckner J et al.| title=Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. | journal=J Clin Oncol | year= 2013 | volume= 31 | issue= 3 | pages= 337-43 | pmid=23071247 | doi=10.1200/JCO.2012.43.2674 | pmc=3732012 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23071247  }} </ref>
*The presence of [[1p36 deletion syndrome|1p]]/19q codeletion is [[Association (statistics)|associated]] with a better [[prognosis]] and greater chemosensitivity.<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="libre119">Molecular Pathology of Oligodendroglioma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Oligodendroglioma</ref><ref name="pmid23429602">{{cite journal| author=Boots-Sprenger SH, Sijben A, Rijntjes J, Tops BB, Idema AJ, Rivera AL et al.| title=Significance of complete 1p/19q co-deletion, IDH1 mutation and MGMT promoter methylation in gliomas: use with caution. | journal=Mod Pathol | year= 2013 | volume= 26 | issue= 7 | pages= 922-9 | pmid=23429602 | doi=10.1038/modpathol.2012.166 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23429602  }} </ref><ref name="pmid16088966">{{cite journal| author=McDonald JM, See SJ, Tremont IW, Colman H, Gilbert MR, Groves M et al.| title=The prognostic impact of histology and 1p/19q status in anaplastic oligodendroglial tumors. | journal=Cancer | year= 2005 | volume= 104 | issue= 7 | pages= 1468-77 | pmid=16088966 | doi=10.1002/cncr.21338 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16088966  }} </ref>
*Several other [[Molecular marker|molecular markers]] have a [[potential]] [[clinical]] [[significance]] as [[isocitrate dehydrogenase|IDH1]] [[mutations]], [[Confirmatory factor analysis|confirming]] the [[strong]] [[prognostic]] [[Role reversal|role]] for overall [[Survival analysis|survival.]]<ref name="pmid24160898">{{cite journal| author=Takahashi Y, Nakamura H, Makino K, Hide T, Muta D, Kamada H et al.| title=Prognostic value of isocitrate dehydrogenase 1, O6-methylguanine-DNA methyltransferase promoter methylation, and 1p19q co-deletion in Japanese malignant glioma patients. | journal=World J Surg Oncol | year= 2013 | volume= 11 | issue=  | pages= 284 | pmid=24160898 | doi=10.1186/1477-7819-11-284 | pmc=3874767 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24160898  }} </ref><ref name="pmid24068788">{{cite journal| author=Wick W, Meisner C, Hentschel B, Platten M, Schilling A, Wiestler B et al.| title=Prognostic or predictive value of MGMT promoter methylation in gliomas depends on IDH1 mutation. | journal=Neurology | year= 2013 | volume= 81 | issue= 17 | pages= 1515-22 | pmid=24068788 | doi=10.1212/WNL.0b013e3182a95680 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24068788  }} </ref><ref name="pmid30943868">{{cite journal| author=Perrech M, Dreher L, Röhn G, Stavrinou P, Krischek B, Toliat M et al.| title=Qualitative and Quantitative Analysis of IDH1 Mutation in Progressive Gliomas by Allele-Specific qPCR and Western Blot Analysis. | journal=Technol Cancer Res Treat | year= 2019 | volume= 18 | issue=  | pages= 1533033819828396 | pmid=30943868 | doi=10.1177/1533033819828396 | pmc=6457076 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30943868  }} </ref><ref name="pmid23934769">{{cite journal| author=Lewandowska MA, Furtak J, Szylberg T, Roszkowski K, Windorbska W, Rytlewska J et al.| title=An analysis of the prognostic value of IDH1 (isocitrate dehydrogenase 1) mutation in Polish glioma patients. | journal=Mol Diagn Ther | year= 2014 | volume= 18 | issue= 1 | pages= 45-53 | pmid=23934769 | doi=10.1007/s40291-013-0050-7 | pmc=3899509 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23934769  }} </ref><ref name="pmid23840696">{{cite journal| author=Yao Y, Chan AK, Qin ZY, Chen LC, Zhang X, Pang JC et al.| title=Mutation analysis of IDH1 in paired gliomas revealed IDH1 mutation was not associated with malignant progression but predicted longer survival. | journal=PLoS One | year= 2013 | volume= 8 | issue= 6 | pages= e67421 | pmid=23840696 | doi=10.1371/journal.pone.0067421 | pmc=3696098 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23840696  }} </ref><ref name="pmid25701198">{{cite journal| author=Olar A, Wani KM, Alfaro-Munoz KD, Heathcock LE, van Thuijl HF, Gilbert MR et al.| title=IDH mutation status and role of WHO grade and mitotic index in overall survival in grade II-III diffuse gliomas. | journal=Acta Neuropathol | year= 2015 | volume= 129 | issue= 4 | pages= 585-96 | pmid=25701198 | doi=10.1007/s00401-015-1398-z | pmc=4369189 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25701198  }} </ref>
*The presence of ''[[EGFR]]'' [[gene mutation]] is [[Association (statistics)|associated]] with a worse [[prognosis|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>
====Clinical factors====
Following is a list of more commonly identified [[clinical]] [[Features (pattern recognition)|features]] that [[Prediction|predict]] '''worse overall [[Survival analysis|survival]]''':
* Older [[age]]
* Poor [[Function (biology)|functional]] status
* [[Baseline (medicine)|Baseline]] [[neurologic]] deficits
* Non[[epilepsy]] [[Presentation (Obstetrics)|presentation]]
* [[Tumor]] [[Location parameter|location]] other than [[frontal]] and [[Parietal lobe|parietal lobes]]
* Large [[tumor]] [[Size consistency|size]] (>4 to 5 cm)
[[Clinical]] [[Features (pattern recognition)|features]] that are [[Independent assortment|independently]] [[Association (statistics)|associated]] with '''improved overall [[Survival analysis|survival]]''' in [[patients]] with '''[[anaplastic]] [[Oligodendroglial tumor|oligodendroglial tumors]]''' include:<ref name="pmid23896377">{{cite journal| author=Gorlia T, Delattre JY, Brandes AA, Kros JM, Taphoorn MJ, Kouwenhoven MC et al.| title=New clinical, pathological and molecular prognostic models and calculators in patients with locally diagnosed anaplastic oligodendroglioma or oligoastrocytoma. A prognostic factor analysis of European Organisation for Research and Treatment of Cancer Brain Tumour Group Study 26951. | journal=Eur J Cancer | year= 2013 | volume= 49 | issue= 16 | pages= 3477-85 | pmid=23896377 | doi=10.1016/j.ejca.2013.06.039 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23896377  }} </ref><ref name="pmid24997140">{{cite journal| author=Panageas KS, Reiner AS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL et al.| title=Recursive partitioning analysis of prognostic variables in newly diagnosed anaplastic oligodendroglial tumors. | journal=Neuro Oncol | year= 2014 | volume= 16 | issue= 11 | pages= 1541-6 | pmid=24997140 | doi=10.1093/neuonc/nou083 | pmc=4201067 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24997140  }} </ref>
* Younger [[age]]
* [[Confirmatory factor analysis|Confirmed]] absence of [[residual]] [[tumor]] by [[imaging]] after [[surgery]]
* [[Frontal]] [[tumor]] [[Location parameter|location]]
* Good [[performance status]]
 
====Tumor grade (II versus III)====
*[[WHO]] [[Grading (tumors)|grade]] III [[anaplastic]] [[oligodendrogliomas]] have worse [[prognosis]] [[Comparability|comparative]] to low-[[Grading (tumors)|grade]] [[tumors]], with an [[average]] [[Difference (philosophy)|difference]] of approximately five [[Year|years]] in overall [[Survival analysis|survival]](11.6 [[Year|years]] for [[Grading (tumors)|grade]] II and 3.5 [[Year|years]] for [[Grading (tumors)|grade]] III).<ref name="pmid25701198" /><ref name="pmid25848751">{{cite journal| author=Suzuki H, Aoki K, Chiba K, Sato Y, Shiozawa Y, Shiraishi Y et al.| title=Mutational landscape and clonal architecture in grade II and III gliomas. | journal=Nat Genet | year= 2015 | volume= 47 | issue= 5 | pages= 458-68 | pmid=25848751 | doi=10.1038/ng.3273 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25848751  }} </ref>
*The 5-[[year]] [[survival rates]] for [[oligodendroglioma]] and [[anaplastic|anaplastic oligodendroglioma]] varying with [[Age|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><ref name="pmid11245209">{{cite journal| author=Giannini C, Scheithauer BW, Weaver AL, Burger PC, Kros JM, Mork S et al.| title=Oligodendrogliomas: reproducibility and prognostic value of histologic diagnosis and grading. | journal=J Neuropathol Exp Neurol | year= 2001 | volume= 60 | issue= 3 | pages= 248-62 | pmid=11245209 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11245209  }} </ref>
 
{| style="border: 0px; font-size: 90%; margin: 3px; width:650px"
| valign="top" |
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|WHO grade of tumor}}
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Age}}
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|5-year survival rate}}
|-
| rowspan="3" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Oligodendroglioma]] ([[Grading (tumors)|Grade]] II)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |20-44
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |82%
|-
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |45-54
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |67%
|-
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |55-64
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |48%
|-
| rowspan="3" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Anaplastic]] [[oligodendroglioma]] ([[Grading (tumors)|Grade]] III)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |20-44
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |64%
|-
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |45-54
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |50%
|-
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |55-64
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |23%
|}
 
====Molecular markers====
*'''1p/19q-codeletion:'''
**Presence of [[1p36 deletion syndrome|1p]]/19q-codeletion is [[Association (statistics)|associated]] with improved [[Survival analysis|survival]] in [[patients]] with [[IDH1|IDH]]-[[mutant]] [[Diffuse gliomatosis|diffuse gliomas]] (with regard to both [[Natural history group|natural history]] of [[disease]] and better [[Response element|response]] to [[therapy]]).<ref name="pmid16782910">{{cite journal| author=Intergroup Radiation Therapy Oncology Group Trial 9402. Cairncross G, Berkey B, Shaw E, Jenkins R, Scheithauer B et al.| title=Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendroglioma: Intergroup Radiation Therapy Oncology Group Trial 9402. | journal=J Clin Oncol | year= 2006 | volume= 24 | issue= 18 | pages= 2707-14 | pmid=16782910 | doi=10.1200/JCO.2005.04.3414 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16782910  }} </ref><ref name="pmid16782911">{{cite journal| author=van den Bent MJ, Carpentier AF, Brandes AA, Sanson M, Taphoorn MJ, Bernsen HJ et al.| title=Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial. | journal=J Clin Oncol | year= 2006 | volume= 24 | issue= 18 | pages= 2715-22 | pmid=16782911 | doi=10.1200/JCO.2005.04.6078 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16782911  }} </ref><ref name="pmid26354927">{{cite journal| author=Dubbink HJ, Atmodimedjo PN, Kros JM, French PJ, Sanson M, Idbaih A et al.| title=Molecular classification of anaplastic oligodendroglioma using next-generation sequencing: a report of the prospective randomized EORTC Brain Tumor Group 26951 phase III trial. | journal=Neuro Oncol | year= 2016 | volume= 18 | issue= 3 | pages= 388-400 | pmid=26354927 | doi=10.1093/neuonc/nov182 | pmc=4767239 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26354927  }} </ref><ref name="pmid28255664">{{cite journal| author=Pekmezci M, Rice T, Molinaro AM, Walsh KM, Decker PA, Hansen H et al.| title=Adult infiltrating gliomas with WHO 2016 integrated diagnosis: additional prognostic roles of ATRX and TERT. | journal=Acta Neuropathol | year= 2017 | volume= 133 | issue= 6 | pages= 1001-1016 | pmid=28255664 | doi=10.1007/s00401-017-1690-1 | pmc=5432658 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28255664  }} </ref><ref name="pmid18371182">{{cite journal| author=Giannini C, Burger PC, Berkey BA, Cairncross JG, Jenkins RB, Mehta M et al.| title=Anaplastic oligodendroglial tumors: refining the correlation among histopathology, 1p 19q deletion and clinical outcome in Intergroup Radiation Therapy Oncology Group Trial 9402. | journal=Brain Pathol | year= 2008 | volume= 18 | issue= 3 | pages= 360-9 | pmid=18371182 | doi=10.1111/j.1750-3639.2008.00129.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18371182  }} </ref><ref name="pmid27651340">{{cite journal| author=Hacisalihoglu P, Kucukodaci Z, Gundogdu G, Bilgic B| title=The Correlation Between 1p/19q Codeletion, IDH1 Mutation, p53 Overexpression and Their Prognostic Roles in 41 Turkish Anaplastic Oligodendroglioma Patients. | journal=Turk Neurosurg | year= 2017 | volume= 27 | issue= 5 | pages= 682-689 | pmid=27651340 | doi=10.5137/1019-5149.JTN.16832-15.1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27651340  }} </ref><ref name="pmid24160898">{{cite journal| author=Takahashi Y, Nakamura H, Makino K, Hide T, Muta D, Kamada H et al.| title=Prognostic value of isocitrate dehydrogenase 1, O6-methylguanine-DNA methyltransferase promoter methylation, and 1p19q co-deletion in Japanese malignant glioma patients. | journal=World J Surg Oncol | year= 2013 | volume= 11 | issue=  | pages= 284 | pmid=24160898 | doi=10.1186/1477-7819-11-284 | pmc=3874767 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24160898  }} </ref>
**Presence of [[polysomy]] of [[Chromosome 1|chromosomes 1]] and [[Chromosome 19|19]] may be useful in identifying [[patients]] with poorer [[prognosis]] who have a [[subset]] of both [[anaplastic]] [[oligodendroglioma]] and a [[Characteristic function (probability theory)|characteristic]] [[1p36 deletion syndrome|1p]]/19q-codeletion.<ref name="pmid19808867">{{cite journal| author=Snuderl M, Eichler AF, Ligon KL, Vu QU, Silver M, Betensky RA et al.| title=Polysomy for chromosomes 1 and 19 predicts earlier recurrence in anaplastic oligodendrogliomas with concurrent 1p/19q loss. | journal=Clin Cancer Res | year= 2009 | volume= 15 | issue= 20 | pages= 6430-7 | pmid=19808867 | doi=10.1158/1078-0432.CCR-09-0867 | pmc=2818514 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19808867  }} </ref><ref name="pmid25007776">{{cite journal| author=Jiang H, Ren X, Zhang Z, Zeng W, Wang J, Lin S| title=Polysomy of chromosomes 1 and 19: an underestimated prognostic factor in oligodendroglial tumors. | journal=J Neurooncol | year= 2014 | volume= 120 | issue= 1 | pages= 131-8 | pmid=25007776 | doi=10.1007/s11060-014-1526-y | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25007776  }} </ref>
**[[Patients]] with [[1p36 deletion syndrome|1p]]/19q [[Loss function|loss]] and [[polysomy]] have a [[Significant figures|significantly]] shorter [[median]] progression-free [[Survival analysis|survival]] [[Comparability|compared]] with those without [[polysomy]].<ref name="pmid19808867">{{cite journal| author=Snuderl M, Eichler AF, Ligon KL, Vu QU, Silver M, Betensky RA et al.| title=Polysomy for chromosomes 1 and 19 predicts earlier recurrence in anaplastic oligodendrogliomas with concurrent 1p/19q loss. | journal=Clin Cancer Res | year= 2009 | volume= 15 | issue= 20 | pages= 6430-7 | pmid=19808867 | doi=10.1158/1078-0432.CCR-09-0867 | pmc=2818514 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19808867  }} </ref>
**[[CIC (gene)|Capicua transcriptional repressor (''CIC'')]] inactivating [[mutations]] are [[Association (statistics)|associated]] with worse [[outcome]] in [[1p36 deletion syndrome|1p]]/19q-codeleted [[oligodendrogliomas|oligodendrogliomas.]]<ref name="pmid26017892">{{cite journal| author=Gleize V, Alentorn A, Connen de Kérillis L, Labussière M, Nadaradjane AA, Mundwiller E et al.| title=CIC inactivating mutations identify aggressive subset of 1p19q codeleted gliomas. | journal=Ann Neurol | year= 2015 | volume= 78 | issue= 3 | pages= 355-74 | pmid=26017892 | doi=10.1002/ana.24443 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26017892  }} </ref>
*'''IDH1/2 mutation:'''
**''[[IDH1]]'' and ''[[IDH2]]'' [[mutations]] are [[Association (statistics)|associated]] with improved [[Survival analysis|survival]] in [[patients]] of [[Glial tumor|glial tumors]], irrespective of the [[Treatments|treatment]] received.<ref name="pmid20160062">{{cite journal| author=van den Bent MJ, Dubbink HJ, Marie Y, Brandes AA, Taphoorn MJ, Wesseling P et al.| title=IDH1 and IDH2 mutations are prognostic but not predictive for outcome in anaplastic oligodendroglial tumors: a report of the European Organization for Research and Treatment of Cancer Brain Tumor Group. | journal=Clin Cancer Res | year= 2010 | volume= 16 | issue= 5 | pages= 1597-604 | pmid=20160062 | doi=10.1158/1078-0432.CCR-09-2902 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20160062  }} </ref><ref name="pmid24160898">{{cite journal| author=Takahashi Y, Nakamura H, Makino K, Hide T, Muta D, Kamada H et al.| title=Prognostic value of isocitrate dehydrogenase 1, O6-methylguanine-DNA methyltransferase promoter methylation, and 1p19q co-deletion in Japanese malignant glioma patients. | journal=World J Surg Oncol | year= 2013 | volume= 11 | issue=  | pages= 284 | pmid=24160898 | doi=10.1186/1477-7819-11-284 | pmc=3874767 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24160898  }} </ref>
**[[Prognostic]] [[significance]] of ''[[IDH1]]/[[IDH2|2]]'' [[mutations]] is equally as [[strong]] as that of the [[1p36 deletion syndrome|1p]]/19q-codeletion.<ref name="pmid24160898">{{cite journal| author=Takahashi Y, Nakamura H, Makino K, Hide T, Muta D, Kamada H et al.| title=Prognostic value of isocitrate dehydrogenase 1, O6-methylguanine-DNA methyltransferase promoter methylation, and 1p19q co-deletion in Japanese malignant glioma patients. | journal=World J Surg Oncol | year= 2013 | volume= 11 | issue=  | pages= 284 | pmid=24160898 | doi=10.1186/1477-7819-11-284 | pmc=3874767 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24160898  }} </ref>
**[[IDH1|IDH]] [[mutations]] are found in [[Diffuse gliomatosis|diffuse gliomas]] with and without the [[1p36 deletion syndrome|1p]]/19q-codeletion.
**North American [[Radiation therapy|Radiation Therapy]] [[Oncology]] Group (RTOG) 9402 and 9802 [[Study design|studies]] [[Suggestion|suggested]] that [[IDH1|IDH]] [[mutations]] are [[Predictive medicine|predictive]] for [[outcome]] to [[adjuvant chemotherapy]], [[Independent assortment|independent]] of other [[molecular]] factors.<ref name="pmid27050206">{{cite journal| author=Buckner JC, Shaw EG, Pugh SL, Chakravarti A, Gilbert MR, Barger GR et al.| title=Radiation plus Procarbazine, CCNU, and Vincristine in Low-Grade Glioma. | journal=N Engl J Med | year= 2016 | volume= 374 | issue= 14 | pages= 1344-55 | pmid=27050206 | doi=10.1056/NEJMoa1500925 | pmc=5170873 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27050206  }} </ref> <ref name="pmid24516018">{{cite journal| author=Cairncross JG, Wang M, Jenkins RB, Shaw EG, Giannini C, Brachman DG et al.| title=Benefit from procarbazine, lomustine, and vincristine in oligodendroglial tumors is associated with mutation of IDH. | journal=J Clin Oncol | year= 2014 | volume= 32 | issue= 8 | pages= 783-90 | pmid=24516018 | doi=10.1200/JCO.2013.49.3726 | pmc=3940537 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24516018  }} </ref>
*'''TERT promoter mutations:'''
**[[Prognostic]] [[significance]] is [[Dependent variable|dependent]] on the [[genetic]] [[background]] of the [[tumor]] (as [[Telomerase reverse transcriptase]] (''[[TERT]]'') [[promoter]] [[mutations]] occur in [[Virtual image|virtually]] all [[1p36 deletion syndrome|1p]]/19q-codeleted, [[IDH1|IDH]]-[[mutant]] [[tumors]] and also in [[glioblastoma]]).
**Negatively [[Association (statistics)|associated]] with [[alpha thalassemia]]/[[mental retardation]] [[syndrome]] [[X-linked]] (''[[ATRX]]'') [[mutations]] (occur in most [[IDH1|IDH]]-[[mutant]] [[astrocytomas]]).
 
====Mechanism of chemosensitivity====
* [[Study design|Studies]] have shown a high [[response rate]] with single-[[Agent study|agent]] [[temozolomide]].
* [[IDH1|IDH]] [[mutations]] result in [[metabolic]] [[Alteratives|alterations]], including:<ref name="pmid26819452">{{cite journal| author=Clark O, Yen K, Mellinghoff IK| title=Molecular Pathways: Isocitrate Dehydrogenase Mutations in Cancer. | journal=Clin Cancer Res | year= 2016 | volume= 22 | issue= 8 | pages= 1837-42 | pmid=26819452 | doi=10.1158/1078-0432.CCR-13-1333 | pmc=4834266 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26819452  }} </ref>
** Decreased [[alpha-ketoglutarate]]
** Increased levels of [[2-hydroxyglutarate dehydrogenase|2-hydroxyglutarate (2HG)]]
** Changes in [[nicotinamide adenine dinucleotide phosphate]] ([[NADP]]) [[Leveling effect|levels]]
** Decrease in [[alpha-ketoglutarate]]
** Increase in [[2-hydroxyglutarate dehydrogenase|2HG]]
* This leads to [[epigenetic]] [[Alteratives|alterations]] and [[development]] of a [[CpG island]] hypermethylated [[phenotype]] (CIMP), which includes ''MGMT'' [[promoter]] [[methylation|methylation.]]<ref name="pmid23948976">{{cite journal| author=van den Bent MJ, Erdem-Eraslan L, Idbaih A, de Rooi J, Eilers PH, Spliet WG et al.| title=MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic Oligodendrogliomas and Oligoastrocytomas. A report from EORTC study 26951. | journal=Clin Cancer Res | year= 2013 | volume= 19 | issue= 19 | pages= 5513-22 | pmid=23948976 | doi=10.1158/1078-0432.CCR-13-1157 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23948976  }} </ref>
* MGMT is a [[nuclear]] [[enzyme]] responsible for [[deoxyribonucleic acid]] ([[DNA]]) repair following [[Alkylating agent|alkylating-agent]] [[chemotherapy]] and may mediate part of the [[cellular]] [[resistance]] to [[Alkylating agent|alkylating agents]].
* ''MGMT'' [[expression]] can be [[Silencer (DNA)|silenced]] by [[methylation]] of its [[promoter|promoter.]]<ref name="pmid11907807">{{cite journal| author=Watanabe T, Nakamura M, Kros JM, Burkhard C, Yonekawa Y, Kleihues P et al.| title=Phenotype versus genotype correlation in oligodendrogliomas and low-grade diffuse astrocytomas. | journal=Acta Neuropathol | year= 2002 | volume= 103 | issue= 3 | pages= 267-75 | pmid=11907807 | doi=10.1007/s004010100464 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11907807  }} </ref>


==References==
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Latest revision as of 14:04, 13 August 2019

Oligodendroglioma Microchapters

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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

  1. ↑ 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
  2. ↑ 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.
  3. ↑ 3.0 3.1 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.
  4. ↑ 4.0 4.1 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.
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ 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.
  9. ↑ Hentschel S, Toyota B (2003). "Intracranial malignant glioma presenting as subarachnoid hemorrhage". Can J Neurol Sci. 30 (1): 63–6. PMID 12619787.
  10. ↑ 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.
  11. ↑ 11.0 11.1 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.
  12. ↑ Hartmann C, Hentschel B, Wick W, Capper D, Felsberg J, Simon M; et al. (2010). "Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas". Acta Neuropathol. 120 (6): 707–18. doi:10.1007/s00401-010-0781-z. PMID 21088844.
  13. ↑ 13.0 13.1 Giannini C, Scheithauer BW, Weaver AL, Burger PC, Kros JM, Mork S; et al. (2001). "Oligodendrogliomas: reproducibility and prognostic value of histologic diagnosis and grading". J Neuropathol Exp Neurol. 60 (3): 248–62. PMID 11245209.
  14. ↑ Hamlat A, Saikali S, Chaperon J, Le Calve M, Gedouin D, Ben-Hassel M; et al. (2005). "Oligodendroglioma: clinical study and survival analysis correlated with chromosomal anomalies". Neurosurg Focus. 19 (5): E15. PMID 16398465.
  15. ↑ Ino Y, Betensky RA, Zlatescu MC, Sasaki H, Macdonald DR, Stemmer-Rachamimov AO; et al. (2001). "Molecular subtypes of anaplastic oligodendroglioma: implications for patient management at diagnosis". Clin Cancer Res. 7 (4): 839–45. PMID 11309331.
  16. ↑ Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C; et al. (2017). "CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014". Neuro Oncol. 19 (suppl_5): v1–v88. doi:10.1093/neuonc/nox158. PMC 5693142. PMID 29117289.
  17. ↑ Lassman AB, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF; et al. (2011). "International retrospective study of over 1000 adults with anaplastic oligodendroglial tumors". Neuro Oncol. 13 (6): 649–59. doi:10.1093/neuonc/nor040. PMC 3107101. PMID 21636710.
  18. ↑ 18.0 18.1 Buckner JC, Shaw EG, Pugh SL, Chakravarti A, Gilbert MR, Barger GR; et al. (2016). "Radiation plus Procarbazine, CCNU, and Vincristine in Low-Grade Glioma". N Engl J Med. 374 (14): 1344–55. doi:10.1056/NEJMoa1500925. PMC 5170873. PMID 27050206.
  19. ↑ van den Bent MJ, Brandes AA, Taphoorn MJ, Kros JM, Kouwenhoven MC, Delattre JY; et al. (2013). "Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951". J Clin Oncol. 31 (3): 344–50. doi:10.1200/JCO.2012.43.2229. PMID 23071237.
  20. ↑ Cairncross G, Wang M, Shaw E, Jenkins R, Brachman D, Buckner J; et al. (2013). "Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402". J Clin Oncol. 31 (3): 337–43. doi:10.1200/JCO.2012.43.2674. PMC 3732012. PMID 23071247.
  21. ↑ Molecular Pathology of Oligodendroglioma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Oligodendroglioma
  22. ↑ Boots-Sprenger SH, Sijben A, Rijntjes J, Tops BB, Idema AJ, Rivera AL; et al. (2013). "Significance of complete 1p/19q co-deletion, IDH1 mutation and MGMT promoter methylation in gliomas: use with caution". Mod Pathol. 26 (7): 922–9. doi:10.1038/modpathol.2012.166. PMID 23429602.
  23. ↑ McDonald JM, See SJ, Tremont IW, Colman H, Gilbert MR, Groves M; et al. (2005). "The prognostic impact of histology and 1p/19q status in anaplastic oligodendroglial tumors". Cancer. 104 (7): 1468–77. doi:10.1002/cncr.21338. PMID 16088966.
  24. ↑ 24.0 24.1 24.2 24.3 Takahashi Y, Nakamura H, Makino K, Hide T, Muta D, Kamada H; et al. (2013). "Prognostic value of isocitrate dehydrogenase 1, O6-methylguanine-DNA methyltransferase promoter methylation, and 1p19q co-deletion in Japanese malignant glioma patients". World J Surg Oncol. 11: 284. doi:10.1186/1477-7819-11-284. PMC 3874767. PMID 24160898.
  25. ↑ Wick W, Meisner C, Hentschel B, Platten M, Schilling A, Wiestler B; et al. (2013). "Prognostic or predictive value of MGMT promoter methylation in gliomas depends on IDH1 mutation". Neurology. 81 (17): 1515–22. doi:10.1212/WNL.0b013e3182a95680. PMID 24068788.
  26. ↑ Perrech M, Dreher L, Röhn G, Stavrinou P, Krischek B, Toliat M; et al. (2019). "Qualitative and Quantitative Analysis of IDH1 Mutation in Progressive Gliomas by Allele-Specific qPCR and Western Blot Analysis". Technol Cancer Res Treat. 18: 1533033819828396. doi:10.1177/1533033819828396. PMC 6457076. PMID 30943868.
  27. ↑ Lewandowska MA, Furtak J, Szylberg T, Roszkowski K, Windorbska W, Rytlewska J; et al. (2014). "An analysis of the prognostic value of IDH1 (isocitrate dehydrogenase 1) mutation in Polish glioma patients". Mol Diagn Ther. 18 (1): 45–53. doi:10.1007/s40291-013-0050-7. PMC 3899509. PMID 23934769.
  28. ↑ Yao Y, Chan AK, Qin ZY, Chen LC, Zhang X, Pang JC; et al. (2013). "Mutation analysis of IDH1 in paired gliomas revealed IDH1 mutation was not associated with malignant progression but predicted longer survival". PLoS One. 8 (6): e67421. doi:10.1371/journal.pone.0067421. PMC 3696098. PMID 23840696.
  29. ↑ 29.0 29.1 Olar A, Wani KM, Alfaro-Munoz KD, Heathcock LE, van Thuijl HF, Gilbert MR; et al. (2015). "IDH mutation status and role of WHO grade and mitotic index in overall survival in grade II-III diffuse gliomas". Acta Neuropathol. 129 (4): 585–96. doi:10.1007/s00401-015-1398-z. PMC 4369189. PMID 25701198.
  30. ↑ 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.
  31. ↑ Gorlia T, Delattre JY, Brandes AA, Kros JM, Taphoorn MJ, Kouwenhoven MC; et al. (2013). "New clinical, pathological and molecular prognostic models and calculators in patients with locally diagnosed anaplastic oligodendroglioma or oligoastrocytoma. A prognostic factor analysis of European Organisation for Research and Treatment of Cancer Brain Tumour Group Study 26951". Eur J Cancer. 49 (16): 3477–85. doi:10.1016/j.ejca.2013.06.039. PMID 23896377.
  32. ↑ Panageas KS, Reiner AS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL; et al. (2014). "Recursive partitioning analysis of prognostic variables in newly diagnosed anaplastic oligodendroglial tumors". Neuro Oncol. 16 (11): 1541–6. doi:10.1093/neuonc/nou083. PMC 4201067. PMID 24997140.
  33. ↑ Suzuki H, Aoki K, Chiba K, Sato Y, Shiozawa Y, Shiraishi Y; et al. (2015). "Mutational landscape and clonal architecture in grade II and III gliomas". Nat Genet. 47 (5): 458–68. doi:10.1038/ng.3273. PMID 25848751.
  34. ↑ 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
  35. ↑ Intergroup Radiation Therapy Oncology Group Trial 9402. Cairncross G, Berkey B, Shaw E, Jenkins R, Scheithauer B; et al. (2006). "Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendroglioma: Intergroup Radiation Therapy Oncology Group Trial 9402". J Clin Oncol. 24 (18): 2707–14. doi:10.1200/JCO.2005.04.3414. PMID 16782910.
  36. ↑ van den Bent MJ, Carpentier AF, Brandes AA, Sanson M, Taphoorn MJ, Bernsen HJ; et al. (2006). "Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial". J Clin Oncol. 24 (18): 2715–22. doi:10.1200/JCO.2005.04.6078. PMID 16782911.
  37. ↑ Dubbink HJ, Atmodimedjo PN, Kros JM, French PJ, Sanson M, Idbaih A; et al. (2016). "Molecular classification of anaplastic oligodendroglioma using next-generation sequencing: a report of the prospective randomized EORTC Brain Tumor Group 26951 phase III trial". Neuro Oncol. 18 (3): 388–400. doi:10.1093/neuonc/nov182. PMC 4767239. PMID 26354927.
  38. ↑ Pekmezci M, Rice T, Molinaro AM, Walsh KM, Decker PA, Hansen H; et al. (2017). "Adult infiltrating gliomas with WHO 2016 integrated diagnosis: additional prognostic roles of ATRX and TERT". Acta Neuropathol. 133 (6): 1001–1016. doi:10.1007/s00401-017-1690-1. PMC 5432658. PMID 28255664.
  39. ↑ Giannini C, Burger PC, Berkey BA, Cairncross JG, Jenkins RB, Mehta M; et al. (2008). "Anaplastic oligodendroglial tumors: refining the correlation among histopathology, 1p 19q deletion and clinical outcome in Intergroup Radiation Therapy Oncology Group Trial 9402". Brain Pathol. 18 (3): 360–9. doi:10.1111/j.1750-3639.2008.00129.x. PMID 18371182.
  40. ↑ Hacisalihoglu P, Kucukodaci Z, Gundogdu G, Bilgic B (2017). "The Correlation Between 1p/19q Codeletion, IDH1 Mutation, p53 Overexpression and Their Prognostic Roles in 41 Turkish Anaplastic Oligodendroglioma Patients". Turk Neurosurg. 27 (5): 682–689. doi:10.5137/1019-5149.JTN.16832-15.1. PMID 27651340.
  41. ↑ 41.0 41.1 Snuderl M, Eichler AF, Ligon KL, Vu QU, Silver M, Betensky RA; et al. (2009). "Polysomy for chromosomes 1 and 19 predicts earlier recurrence in anaplastic oligodendrogliomas with concurrent 1p/19q loss". Clin Cancer Res. 15 (20): 6430–7. doi:10.1158/1078-0432.CCR-09-0867. PMC 2818514. PMID 19808867.
  42. ↑ Jiang H, Ren X, Zhang Z, Zeng W, Wang J, Lin S (2014). "Polysomy of chromosomes 1 and 19: an underestimated prognostic factor in oligodendroglial tumors". J Neurooncol. 120 (1): 131–8. doi:10.1007/s11060-014-1526-y. PMID 25007776.
  43. ↑ Gleize V, Alentorn A, Connen de Kérillis L, Labussière M, Nadaradjane AA, Mundwiller E; et al. (2015). "CIC inactivating mutations identify aggressive subset of 1p19q codeleted gliomas". Ann Neurol. 78 (3): 355–74. doi:10.1002/ana.24443. PMID 26017892.
  44. ↑ van den Bent MJ, Dubbink HJ, Marie Y, Brandes AA, Taphoorn MJ, Wesseling P; et al. (2010). "IDH1 and IDH2 mutations are prognostic but not predictive for outcome in anaplastic oligodendroglial tumors: a report of the European Organization for Research and Treatment of Cancer Brain Tumor Group". Clin Cancer Res. 16 (5): 1597–604. doi:10.1158/1078-0432.CCR-09-2902. PMID 20160062.
  45. ↑ Cairncross JG, Wang M, Jenkins RB, Shaw EG, Giannini C, Brachman DG; et al. (2014). "Benefit from procarbazine, lomustine, and vincristine in oligodendroglial tumors is associated with mutation of IDH". J Clin Oncol. 32 (8): 783–90. doi:10.1200/JCO.2013.49.3726. PMC 3940537. PMID 24516018.
  46. ↑ Clark O, Yen K, Mellinghoff IK (2016). "Molecular Pathways: Isocitrate Dehydrogenase Mutations in Cancer". Clin Cancer Res. 22 (8): 1837–42. doi:10.1158/1078-0432.CCR-13-1333. PMC 4834266. PMID 26819452.
  47. ↑ van den Bent MJ, Erdem-Eraslan L, Idbaih A, de Rooi J, Eilers PH, Spliet WG; et al. (2013). "MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic Oligodendrogliomas and Oligoastrocytomas. A report from EORTC study 26951". Clin Cancer Res. 19 (19): 5513–22. doi:10.1158/1078-0432.CCR-13-1157. PMID 23948976.
  48. ↑ Watanabe T, Nakamura M, Kros JM, Burkhard C, Yonekawa Y, Kleihues P; et al. (2002). "Phenotype versus genotype correlation in oligodendrogliomas and low-grade diffuse astrocytomas". Acta Neuropathol. 103 (3): 267–75. doi:10.1007/s004010100464. PMID 11907807.


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