Oligoastrocytoma 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
If left untreated, patients with oligoastrocytoma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[1][2][3] Oligoastrocytomas are slow growing tumors.[4] Common complications associated with oligoastrocytoma include hydrocephalus, intracranial hemorrhage, coma, metastasis, venous thromboembolism, and side effects of chemotherapy and radiation.[2][5][6][1][7][3] 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.[8] The prognosis for patients with oligoastrocytoma is more favorable than that for anaplastic oligoastrocytoma because of the more indolent course and younger age at which most patients are diagnosed.[2] The 1, 5, and 10-year survival rates of patients with oligoastrocytoma are approximately 87%, 56.97%, and 45.80%.[9]
Natural history
- Oligoastrocytomas are slow growing tumors.[4] The tumors may be present for many years before they are diagnosed.[10]
- If left untreated, patients with oligoastrocytoma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[1][2][3]
- 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.[11]
Complications
Common complications associated with oligoastrocytoma include:[2][5][6][1][7][3]
- Hydrocephalus
- Intracranial hemorrhage
- Coma
- Metastasis
- Recurrence
- Venous thromboembolism
- 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 oligoastrocytoma may vary. However, the prognosis is generally regarded as good.[8]
- The prognosis for patients with oligoastrocytoma is more favorable than that for anaplastic oligoastrocytoma because of the more indolent course and younger age at which most patients are diagnosed.[2]
- The 1, 5, and 10-year survival rates of patients with oligoastrocytoma are approximately 87%, 56.97%, and 45.80%.[9]
- Favorable prognostic factors for oligoastrocytoma include:[12][13][5][14][15][1]
- Presence of 1p19q codeletion
- Age at presentation < 40 years
- Lower grade of tumor
- Absence of tumor necrosis
- Seizure as presenting symptom
- Presence of MGMT gene promoter hypermethylation
- Extent of surgical resection
- Good performance status
- Intact neurological function
- Presence of microvascular proliferation and necrosis are poor prognostic factors for oligoastrocytoma.[16]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Chandana SR, Movva S, Arora M, Singh T (2008). "Primary brain tumors in adults". Am Fam Physician. 77 (10): 1423–30. PMID 18533376.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 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.
- ↑ 3.0 3.1 3.2 3.3 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.
- ↑ 4.0 4.1 Adesina, Adekunle (2010). Atlas of pediatric brain tumors. New York: Springer. ISBN 9781441910622.
- ↑ 5.0 5.1 5.2 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.
- ↑ 6.0 6.1 Signs and symptoms of glioma. Wikipedia 2015. https://en.wikipedia.org/wiki/Glioma. Accessed on October 20, 2015
- ↑ 7.0 7.1 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.
- ↑ 8.0 8.1 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.
- ↑ 9.0 9.1 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
- ↑ 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
- ↑ 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
- ↑ 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
- ↑ Naugle DK, Duncan TD, Grice GP (2004). "Oligoastrocytoma". Radiographics. 24 (2): 598–600. doi:10.1148/rg.242035069. PMID 15026604.
- ↑ Prognosis of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015
- ↑ 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.
- ↑ 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.