Glioma natural history, complications and prognosis

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

Overview

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

Complications

Common complications of glioma include:

• Brain herniation
• Hydrocephalus
• Coma
• Metastasis
• Recurrence
• Side effects of chemotherapy
• Side effects of radiation therapy

Prognosis

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

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

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