Functional outcomes and survival in patients with high-grade gliomas in dominant and nondominant hemispheres

Abstract

Laterality of high-grade gliomas is not an independent prognostic factor for predicting survival or functional outcome. The findings in this study demonstrate that fears of increased postoperative morbidity or mortality in otherwise resectable tumors of the DH are unfounded, and the authors therefore advocate that the surgeon's decision to operate be guided by validated outcome predictors and not biased by tumor lateralization.

Gene expression profile as a prognostic factor in high-grade gliomas

“…We have found a shorter survival for patients with neurological deficit as the first symptom of disease. In our cohort of patients, age was also found to be a significant prognostic factor, which is consistent with other studies (1,4,6,7,(9)(10)(11). Gross total vs. subtotal resection did not influence prognosis, contrary to other reports (1,9,10).…”

“…Previous studies on the effect of postoperative KPS score upon prognosis presented various conclusions. Some studies indicated an advantage of a better postoperative status on time of survival (1,4,6,7,10), whereas other authors did not report that relationship (9,11). Our patients with an excellent postoperative status (100 points in KPS), in contrast to patients showing symptoms or signs of disease, had a significantly longer survival time.…”

“…Despite a grave prognosis in all high-grade gliomas (1,4,(6)(7)(8)21,36,63), some variability in survival has been noted (2,3,5). It is very likely that in the near future also prognosis in high-grade gliomas based on clinical factors and histopathological evaluation, will, at least partially, be replaced by prognosis based on gene expression (12,68).…”

“…The mean survival time in glioblastomas is <1 year, in anaplastic astrocytomas up to 3 years. However, survival does vary among patients (1)(2)(3)(4)(5)(6)(7)(8). An unexpected clinical course reflects primarily biological differences between these tumors.…”

“…An unexpected clinical course reflects primarily biological differences between these tumors. A few clinical factors such as age, Karnofsky performance status, extent of tumour resection, have been identified as useful in assessing the prognosis (4,6,7,(9)(10)(11). However, genetic heterogeneity of the tumours may exert the most significant influence on differences in the survival period (3,12).…”