Cancer Res Treat.  2020 Oct;52(4):1041-1049. 10.4143/crt.2020.057.

Survival, Prognostic Factors, and Volumetric Analysis of Extent of Resection for Anaplastic Gliomas

• Hong JB
• Roh TH
• Kang SG
• Kim SH
• Moon JH
• Kim EH
• Ahn SS
• Choi HJ
• Cho J
• Suh CO
• Chang JH

• KMID: 2507931
• DOI: http://doi.org/10.4143/crt.2020.057

Abstract

Purpose
The aim of this study is to evaluate the survival rate and prognostic factors of anaplastic gliomas according to the 2016 World Health Organization classification, including extent of resection (EOR) as measured by contrast-enhanced T1-weighted magnetic resonance imaging (MRI) and the T2-weighted MRI.
Materials and Methods
The records of 113 patients with anaplastic glioma who were newly diagnosed at our institute between 2000 and 2013 were retrospectively reviewed. There were 62 cases (54.9%) of anaplastic astrocytoma, isocitrate dehydrogenase (IDH) wild-type (AAw), 18 cases (16.0%) of anaplastic astrocytoma, IDH-mutant, and 33 cases (29.2%) of anaplastic oligodendroglioma, IDH-mutant and 1p/19q-codeleted.
Results
The median overall survival (OS) was 48.4 months in the whole anaplastic glioma group and 21.5 months in AAw group. In multivariate analysis, age, preoperative Karnofsky Performance Scale score, O⁶-methylguanine-DNA methyltransferase (MGMT) methylation status, postoperative tumor volume, and EOR measured from the T2 MRI sequence were significant prognostic factors. The EOR cut-off point for OS measured in contrast-enhanced T1-weighted MRI and T2-weighted MRI were 99.96% and 85.64%, respectively.
Conclusions
We found that complete resection of the contrast-enhanced portion (99.96%) and more than 85.64% resection of the non-enhanced portion of the tumor have prognostic impacts on patient survival from anaplastic glioma.

Keyword

Anaplastic glioma; Extent of resection; Survival; Prognosis

Figure

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  Fig. 1. Overall survival. (A) Kaplan-Meier representation of overall survival time for the entire group of 113 patients. (B) Kaplan-Meier representation of overall survival time for the AAw, AAm, AOmc each group. AAm, anaplastic astrocytoma, IDH-mutant; AAw, anaplastic astrocytoma, IDH-wildtype; AOmc, anaplastic oligodendroglioma, IDH-mutant and 1p/19q-codeleted; GIII, grade III glioma.

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  Fig. 2. Progression-free survival. (A) Kaplan-Meier representation of progression-free survival time for the entire group of 113 patients. (B) Kaplan-Meier representation of progression-free survival time for the AAw, AAm, AOmc each group. AAm, anaplastic astrocytoma, IDH-mutant; AAw, anaplastic astrocytoma, IDH-wildtype; AOmc, anaplastic oligodendroglioma, IDH-mutant and 1p/19q-codeleted; GIII, grade III glioma.

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  Fig. 3. Overall survival. (A) Kaplan-Meier representation of overall survival time according to EOR (T1CE). (B) Kaplan-Meier representation of overall survival time according to EOR (T2). EOR, extent of resection; T1CE, T1-weighted contrast-enhanced magnetic resonance imaging (MRI); T2, T2-weighted MRI.

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  Fig. 4. Progression-free survival. (A) Kaplan-Meier representation of progression-free survival time according to EOR (T1CE). (B) Kaplan-Meier representation of progression-free survival time according to EOR (T2). EOR, extent of resection; T1CE, T1-weighted contrast-enhanced magnetic resonance imaging (MRI); T2, T2-weighted MRI.

Reference

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