Prognostic significance of clinical parameters in patients with cerebral low-grade glioma

Abstract

Introduction/Objective Low-grade gliomas affect younger adults and carry a favorable prognosis. We aim to describe clinical patterns of low-grade gliomas as well as prognosis in different groups of patients. Our intention was to determine clinical parameters that may affect prognosis, and whether a greater extent of resection would increase the long-term progression-free or overall survival of patients with low-grade gliomas.

Methods We analyzed data obtained from the files of the patients with a diagnosis of the World Health Organization classification grade II gliomas. The relationships among categorical variables were analyzed using standard statistical tools and a 95% confidence interval.

Results We analyzed 118 patients with median age of 34 years. Over 57% were male and the primary site location was the cerebrum. All these patients were operated on and some of them received radiation and/ or chemotherapy. Median overall survival was 9.6 years and better prognosis is associated with younger age, frontal and noneloquent zone location, seizures as the first symptom of the disease, and gross total resection of the tumor. Indications for early surgery are increased intracranial pressure, preoperative neurologic deficit, tumor size larger than 6 cm with contrast enhancement, and older age.

Conclusion Tumor location, 1p/19q co-deletion, and age were the main determinants of treatment received and overall survival, likely reflecting tumor biology differences. Any form of treatment was preferred over watchful waiting. This study found that a greater extent of resection could significantly increase the overall survival of patients with low-grade gliomas.

Keywords: low-grade glioma; surgery; prognosis; survival