Prognostic factors and outcomes in anaplastic gliomas: An institutional experience

Abstract

Background:There is lack of clear evidence and treatment guidelines for anaplastic gliomas (AGs) with very few studies focusing exclusively on these patients. The aim of the study was to analyze the clinical profile and survival in these patients.Materials and Methods:Patients of AGs treated with radiation and concurrent ± adjuvant chemotherapy from January 2010 to December 2015 were analyzed. Statistical analysis was done using SPSS version 20 software.Results:A total of 100 patients were included in the study. The median age was 35 years (range 6–68 years). Eighty-four patients had follow-up details and were included for survival analysis. The 5-year overall survival (OS) was 58%. Age, presentation with seizures, and focal neurological deficit were not found to significantly influence survival. The 5-year survival for oligodendroglioma and astrocytoma was 69% and 52%, respectively. Patients with Karnofsky Performance Score (KPS) of ≥70 had a significantly better 5-year OS (65%) as compared to those with KPS <70 (33%) (P = 0.000). The use of adjuvant temozolomide (TMZ) showed longer 5-year OS of 67.7% compared to 36% in patients who did not receive adjuvant chemotherapy (P = 0.018). Patients receiving both concurrent and adjuvant TMZ showed longer 5-year OS (68.5% vs. 40%, P = 0.010). Twenty-two patients had recurrence with average time to recurrence being 37 months. Fourteen patients underwent salvage surgery and two patients received reirradiation.Conclusions:OS significantly correlated with KPS and receipt of concurrent and adjuvant chemotherapy with TMZ. Therefore, adjuvant radiation with concurrent and adjuvant TMZ should be the standard of care for AGs.

The Outcome of Anaplastic Glioma Treated at a Tertiary Cancer Care Institute in South Asia

“…In our study, patients treated with adjuvant chemoradiation followed by adjuvant temozolomide showed better outcomes. Deepthi Valiyaveettil [19] et al's study also showed that concurrent and adjuvant temozolomide patients had better survival rates. Emory McTyre [20] that had1p/19q co-deleted patients and is for RT followed by PCV versus TMZ concurrent with RT followed by adjuvant TMZ versus TMZ alone.…”

Case report: Diagnostic challenge: a new multiple sclerosis “relapse” leading to the diagnosis of anaplastic astrocytoma

“…The prognosis of this type of tumor is rather poor, with a mean 5-year survival of 28.6% (11), which increases to 41.8% if the patient receives adjuvant chemo-and radiotherapy (12). For overall survival, positive prognostic factors have been described: age (<41), isocitrate dehydrogenase mutation, radical resection and Karnofsky performance status of at least 90% (13), however, another source states a positive effect of Karnofsky performance status of at least 70% (14). In the latter case (Karnofsky performance status of 70%), our patient would have all of the positive factors mentioned above.…”

Therapeutic Options and Prognostic Factors in Treatment of Anaplastic Gliomas

“…Other studies showed that patients with Karnofsky Performance Score (KPS) of ≥70 have a significantly better 5-year OS(Overall Survival) as compared to those with KPS <70 (33%) . The use of adjuvant temozolomide (TMZ) shows longer 5-year OS compared to 36% in patients who did not receive adjuvant chemotherapy (20) Unfortunately, we cannot get a general conclusion about the epidemiological characteristics of anaplastic gliomas on the entire territory of the Republic of Serbia, due to the lack of precise unified data. Radical surgery, which is not an end in itself, is one of the basic prognostic factors.…”