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 oligodendroglioma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[1] Common complications associated with oligodendroglioma include hydrocephalus, intracranial hemorrhage, coma, bone marrow metastasis, recurrence, venous thromboembolism, parkinsonism, and side effects of chemotherapy and radiotherapy.[2][3][4][5][6][7][8] 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. The median survival time for oligodendroglioma is 11.6 years for grade II and 3.5 years for grade III.[9]

Natural history

  • Oligoastrocytomas are slow growing tumors.[10] The tumors may be present for many years before they are diagnosed.[11]
  • Anaplastic oligodendroglioma usually grows 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 seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[1]
  • Recurrence is a very common feature of oligodendrogliomas. It can be either of the same grade or higher grade at the primary site.[12]
  • 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 .[13]

Complications

Common complications associated with oligoastrocytoma include:[14][15][16][17][18]

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.[19]
  • 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.[20]
  • The 1, 5, and 10-year survival rates of patients with oligoastrocytoma are approximately 87%, 56.97%, and 45.80%.[21]
  • Favorable prognostic factors for oligoastrocytoma include:[22][23][14][24][25][16]
  • Presence of microvascular proliferation and necrosis are poor prognostic factors for oligoastrocytoma.[26]

References

  1. ↑ 1.0 1.1 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ Hentschel S, Toyota B (2003). "Intracranial malignant glioma presenting as subarachnoid hemorrhage". Can J Neurol Sci. 30 (1): 63–6. PMID 12619787.
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ Adesina, Adekunle (2010). Atlas of pediatric brain tumors. New York: Springer. ISBN 9781441910622.
  11. ↑ 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
  12. ↑ 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.
  13. ↑ 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
  14. ↑ 14.0 14.1 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.
  15. ↑ Signs and symptoms of glioma. Wikipedia 2015. https://en.wikipedia.org/wiki/Glioma. Accessed on October 20, 2015
  16. ↑ 16.0 16.1 Chandana SR, Movva S, Arora M, Singh T (2008). "Primary brain tumors in adults". Am Fam Physician. 77 (10): 1423–30. PMID 18533376.
  17. ↑ 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.
  18. ↑ 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.
  19. ↑ 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.
  20. ↑ 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.
  21. ↑ 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
  22. ↑ 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
  23. ↑ Naugle DK, Duncan TD, Grice GP (2004). "Oligoastrocytoma". Radiographics. 24 (2): 598–600. doi:10.1148/rg.242035069. PMID 15026604.
  24. ↑ Prognosis of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015
  25. ↑ 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.
  26. ↑ 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.


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