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Prognostic implication of histological oligodendroglial tumor component: clinicopathological analysis of 111 cases of malignant gliomas.

Kanno H, Nishihara H, Narita T, Yamaguchi S, Kobayashi H, Tanino M, Kimura T, Terasaka S, Tanaka S - PLoS ONE (2012)

Bottom Line: In this study, we performed a histopathology-based reevaluation of 111 cases of high grade gliomas according to the latest World Health Organization (WHO), and compared the clinical outcomes between oligodendroglial tumors and pure astrocytic tumors.The survival analysis revealed that the patients with high grade oligodendroglial tumor including GBMO significantly indicated better prognosis compared to the patients with high grade pure astrocytic tumors (GBM and AA, anaplastic astrocytoma) as expected, and the obtained survival curves were almost identical to those from the patients with conventional Grade III or Grade IV tumors, respectively.This is the prominent report of retrospective clinicopathological analysis for high-grade gliomas throughout Grade III and IV, especially referring to the prognostic value of histological oligodendroglial tumor component; in addition, our results might offer an alternative aspect for the grading of high-grade astrocytic/oligodendroglial tumors.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Cancer Research, Department of Pathology, Hokkaido University School of Medicine, Sapporo, Japan.

ABSTRACT
The favorable prognosis of high-grade oligodendroglial tumor such as glioblastoma (GBM) with oligodendroglioma component (GBMO) has been suggested; however, the studies which examine the prognostic significance of oligodendroglial tumor were limited. In this study, we performed a histopathology-based reevaluation of 111 cases of high grade gliomas according to the latest World Health Organization (WHO), and compared the clinical outcomes between oligodendroglial tumors and pure astrocytic tumors. The survival analysis revealed that the patients with high grade oligodendroglial tumor including GBMO significantly indicated better prognosis compared to the patients with high grade pure astrocytic tumors (GBM and AA, anaplastic astrocytoma) as expected, and the obtained survival curves were almost identical to those from the patients with conventional Grade III or Grade IV tumors, respectively. Moreover, if the cases of oligodendroglial tumor were histopathologically excluded, the patients with AA exhibited extremely poor prognosis which was similar to that of GBM, suggesting that the histological identification of oligodendroglial tumor component, even partially, prescribe the prognosis of high grade glioma patients. This is the prominent report of retrospective clinicopathological analysis for high-grade gliomas throughout Grade III and IV, especially referring to the prognostic value of histological oligodendroglial tumor component; in addition, our results might offer an alternative aspect for the grading of high-grade astrocytic/oligodendroglial tumors.

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Overall survival analysis of AA and GBM according to the treatment variations.The graph shows comparison of OS between AA and GBM patients who underwent Nimustine hydrochloride (ACNU) - based chemotherapy (a), Temozolomide (TMZ) - based chemotherapy (b), and 60 Gy of radiation therapy (c). There is no statistical siginificance.
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pone-0041669-g004: Overall survival analysis of AA and GBM according to the treatment variations.The graph shows comparison of OS between AA and GBM patients who underwent Nimustine hydrochloride (ACNU) - based chemotherapy (a), Temozolomide (TMZ) - based chemotherapy (b), and 60 Gy of radiation therapy (c). There is no statistical siginificance.

Mentions: The overall survival (OS) based on the conventional grading entities of gliomas, i.e. Grade III (AO, AOA and AA) versus Grade IV (GBM and GBMO) by the Kaplan-Meier method is shown in Fig. 2a, and is approximately similar to that described in previous reports [12], [13]. Between GBM and GBMO, the statistical significance of OS was not obtained, although the progression-free survival (PFS) of GBMO was statistically better than that of GBM (pā€Š=ā€Š0.0456) (Fig. 2b and 3b). To clarify the prognostic value of the presence of oligodendroglial tumor component, we divided all cases into two groups regardless of WHO grading, i.e., oligodendroglial tumor (AO, AOA, GBMO) and pure astrocytic tumor (AA, GBM), and obtained the interesting result that the both OS and PFS of oligodendroglial tumor were significantly better than these of pure astrocytic tumor (Fig. 2c and 3c). Furthermore, we found the striking data between AA and GBM; their survival curves of the OS and the PFS were almost identical (Fig. 2d, 3d and S3). In our facility, the patients with pathological Grade III glioma (AA, AO and AOA) were treated with a smaller amount of radiation (54 Gy) compared to the patients with Grade IV (GBM and GBMO; 60 Gy), and the selection of chemotherapy varied according to the standard protocol of the time of onset. To exclude the possible effects due to the variation of chemotherapy and the total amount of irradiation, we analyzed the OS between AA and GBM with ACNU, TMZ, or 60 Gy of irradiation, respectively, and confirmed that the OS and PFS were not affected by the variation of the treatment (Fig. 4).


Prognostic implication of histological oligodendroglial tumor component: clinicopathological analysis of 111 cases of malignant gliomas.

Kanno H, Nishihara H, Narita T, Yamaguchi S, Kobayashi H, Tanino M, Kimura T, Terasaka S, Tanaka S - PLoS ONE (2012)

Overall survival analysis of AA and GBM according to the treatment variations.The graph shows comparison of OS between AA and GBM patients who underwent Nimustine hydrochloride (ACNU) - based chemotherapy (a), Temozolomide (TMZ) - based chemotherapy (b), and 60 Gy of radiation therapy (c). There is no statistical siginificance.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3404002&req=5

pone-0041669-g004: Overall survival analysis of AA and GBM according to the treatment variations.The graph shows comparison of OS between AA and GBM patients who underwent Nimustine hydrochloride (ACNU) - based chemotherapy (a), Temozolomide (TMZ) - based chemotherapy (b), and 60 Gy of radiation therapy (c). There is no statistical siginificance.
Mentions: The overall survival (OS) based on the conventional grading entities of gliomas, i.e. Grade III (AO, AOA and AA) versus Grade IV (GBM and GBMO) by the Kaplan-Meier method is shown in Fig. 2a, and is approximately similar to that described in previous reports [12], [13]. Between GBM and GBMO, the statistical significance of OS was not obtained, although the progression-free survival (PFS) of GBMO was statistically better than that of GBM (pā€Š=ā€Š0.0456) (Fig. 2b and 3b). To clarify the prognostic value of the presence of oligodendroglial tumor component, we divided all cases into two groups regardless of WHO grading, i.e., oligodendroglial tumor (AO, AOA, GBMO) and pure astrocytic tumor (AA, GBM), and obtained the interesting result that the both OS and PFS of oligodendroglial tumor were significantly better than these of pure astrocytic tumor (Fig. 2c and 3c). Furthermore, we found the striking data between AA and GBM; their survival curves of the OS and the PFS were almost identical (Fig. 2d, 3d and S3). In our facility, the patients with pathological Grade III glioma (AA, AO and AOA) were treated with a smaller amount of radiation (54 Gy) compared to the patients with Grade IV (GBM and GBMO; 60 Gy), and the selection of chemotherapy varied according to the standard protocol of the time of onset. To exclude the possible effects due to the variation of chemotherapy and the total amount of irradiation, we analyzed the OS between AA and GBM with ACNU, TMZ, or 60 Gy of irradiation, respectively, and confirmed that the OS and PFS were not affected by the variation of the treatment (Fig. 4).

Bottom Line: In this study, we performed a histopathology-based reevaluation of 111 cases of high grade gliomas according to the latest World Health Organization (WHO), and compared the clinical outcomes between oligodendroglial tumors and pure astrocytic tumors.The survival analysis revealed that the patients with high grade oligodendroglial tumor including GBMO significantly indicated better prognosis compared to the patients with high grade pure astrocytic tumors (GBM and AA, anaplastic astrocytoma) as expected, and the obtained survival curves were almost identical to those from the patients with conventional Grade III or Grade IV tumors, respectively.This is the prominent report of retrospective clinicopathological analysis for high-grade gliomas throughout Grade III and IV, especially referring to the prognostic value of histological oligodendroglial tumor component; in addition, our results might offer an alternative aspect for the grading of high-grade astrocytic/oligodendroglial tumors.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Cancer Research, Department of Pathology, Hokkaido University School of Medicine, Sapporo, Japan.

ABSTRACT
The favorable prognosis of high-grade oligodendroglial tumor such as glioblastoma (GBM) with oligodendroglioma component (GBMO) has been suggested; however, the studies which examine the prognostic significance of oligodendroglial tumor were limited. In this study, we performed a histopathology-based reevaluation of 111 cases of high grade gliomas according to the latest World Health Organization (WHO), and compared the clinical outcomes between oligodendroglial tumors and pure astrocytic tumors. The survival analysis revealed that the patients with high grade oligodendroglial tumor including GBMO significantly indicated better prognosis compared to the patients with high grade pure astrocytic tumors (GBM and AA, anaplastic astrocytoma) as expected, and the obtained survival curves were almost identical to those from the patients with conventional Grade III or Grade IV tumors, respectively. Moreover, if the cases of oligodendroglial tumor were histopathologically excluded, the patients with AA exhibited extremely poor prognosis which was similar to that of GBM, suggesting that the histological identification of oligodendroglial tumor component, even partially, prescribe the prognosis of high grade glioma patients. This is the prominent report of retrospective clinicopathological analysis for high-grade gliomas throughout Grade III and IV, especially referring to the prognostic value of histological oligodendroglial tumor component; in addition, our results might offer an alternative aspect for the grading of high-grade astrocytic/oligodendroglial tumors.

Show MeSH
Related in: MedlinePlus