Glioma natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The prognosis of glioma is poor.

Natural history

Gliomas are highly heterogeneous, infiltrative and diffuse, with different degrees of invasiveness. They can penetrate through the brain, colonizing the entire organ, sending their invasive cells far beyond the principal tumor mass. Despite this considerable invasive ability, gliomas rarely leave the nervous tissue to colonize other organs, remaining confined in the skull, with only little evidence of systemic spread.

Complications

Common complications of glioma include:

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

Prognosis

The prognosis for 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.

The prognosis for glioma may depend on other factors which include:

• Tumor is in the brain or spinal cord
• Whether the tumor can be removed by surgery
• Whether the cancer has just been diagnosed or has recurred
• 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