Oligodendroglioma natural history, complications, and prognosis: Difference between revisions
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==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> | *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> | ||
*[[ | *Only 30% of oligodendroglial tumors have anaplastic characteristics.<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> | ||
*[[Anaplastic|Anaplastic oligodendroglioma]] usually grow quickly. These tumors may develop in one place or in many places throughout the brain. | |||
*If left untreated, patients with oligodendroglioma may progress to develop focal neurological deficits, [[altered mental status]], [[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> | *If left untreated, patients with oligodendroglioma may progress to develop focal neurological deficits, [[altered mental status]], [[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> | ||
*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> | *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> |
Revision as of 18:15, 13 October 2015
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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
Natural history
- Oligodendrogliomas tend to be low grade and less aggressive than other types of gliomas. These tumors are slow growing. The tumors may be present for many years before they are diagnosed.[1]
- Only 30% of oligodendroglial tumors have anaplastic characteristics.[2]
- Anaplastic oligodendroglioma usually grow quickly. These tumors may develop in one place or in many places throughout the brain.
- If left untreated, patients with oligodendroglioma may progress to develop focal neurological deficits, altered mental status, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[3]
- Recurrence is a very common feature of oligodendrogliomas. It can be either of the same grade or higher grade at the primary site.[4]
- 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.[4]
Complications
Common complications associated with oligodendroglioma include:[5][6][7][8][9]
- Hydrocephalus
- Intracranial hemorrhage
- Coma
- Bone marrow metastasis
- Recurrence
- Side effects of chemotherapy
- Side effects of radiotherapy
Prognosis
- 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.[10]
- 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 presence of the 1p19q codeletion is a relevant marker of longer overall survival in patients with low grade oligodendrogliomas and isocitrate dehydrogenase 1 (IDH1) mutation.[11]
- IDH1 positive + 1p19q codeletion = better prognosis
- IDH1 positive + no 1p19q codeletion = shorter overall survival
- Presence of EGFR gene mutation is associated with poorer prognosis.[12]
- The 5-year survival rates for oligodendroglioma and anaplastic oligodendroglioma varying with ages are tabulated below:[13]
WHO grade of tumor | Age | 5-year survival rate |
---|---|---|
Oligodendroglioma (Grade II) | 20-44 | 82% |
45-54 | 67% | |
55-64 | 48% | |
Anaplastic oligodendroglioma (Grade III) | 20-44 | 64% |
45-54 | 50% | |
55-64 | 23% |
References
- ↑ Survival by prognostic factors. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/prognosis-and-survival/survival-statistics/?region=on
- ↑ 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.
- ↑ 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.
- ↑ 4.0 4.1 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.
- ↑ Guppy KH, Akins PT, Moes GS, Prados MD (2009). "Spinal cord oligodendroglioma with 1p and 19q deletions presenting with cerebral oligodendrogliomatosis". J Neurosurg Spine. 10 (6): 557–63. doi:10.3171/2009.2.SPINE08853. PMID 19558288.
- ↑ Sharma A, Agarwal A, Sharma MC, Anand M, Agarwal S, Raina V (2003). "Bone marrow metastasis in anaplastic oligodendroglioma". Int J Clin Pract. 57 (4): 351–2. PMID 12800473.
- ↑ Solitare GB, Robinson F, Lamarche JB (1967). "Oligodendroglioma: recurrence following an exceptionally long postoperative symptom-free interval". Can Med Assoc J. 97 (14): 862–5. PMC 1923454. PMID 6051252.
- ↑ Harada K, Kiya K, Matsumura S, Mori S, Uozumi T (1982). "Spontaneous intracranial hemorrhage caused by oligodendroglioma--a case report and review of the literature". Neurol Med Chir (Tokyo). 22 (1): 81–4. PMID 6176898.
- ↑ Hentschel S, Toyota B (2003). "Intracranial malignant glioma presenting as subarachnoid hemorrhage". Can J Neurol Sci. 30 (1): 63–6. PMID 12619787.
- ↑ Ohgaki H, Kleihues P (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.
- ↑ 1p19q codeletion. Dr. Bruno Di Muzio et al. http://radiopaedia.org/articles/1p19q-codeletion
- ↑ 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.
- ↑ 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