Jung Tae-Young, Jung Shin, Moon Jung-Ho, Kim In-Young, Moon Kyung-Sub, Jang Woo-Youl
Department of Neurosurgery, Chonnam National University Hwasun Hospital & Medical School, Gwangju, South Korea.
Clin Neurol Neurosurg. 2011 Nov;113(9):752-7. doi: 10.1016/j.clineuro.2011.08.002. Epub 2011 Sep 1.
Low-grade gliomas (LGGs) are infiltrative tumors characterized by slow growth. However, during early period, LGGs can progress and transform into a malignant pathology. We analyzed the prognostic factors for progression and malignant transformation in LGGs.
From 2000 to 2009, we operated on 86 patients: 42 oligodendrogliomas, 12 oligoastrocytomas, and 32 astrocytomas. The male:female ratio was 47:39, and the median age was 41 (±17.4) years. The mean follow-up period was 4.25 (±2.8) years. We analyzed the prognostic factors for progression-free survival (PFS), overall survival (OS), and malignant transformation, considering age, sex, KPS, clinical presentation, tumor location, radiologic pattern, extent of removal, pathologic subtype, and adjuvant treatment.
In univariate analysis, non-eloquent location, gross total removal, and oligodendroglial pathology statistically correlated with improved PFS and OS. In multivariate analysis, gross total removal correlated with longer PFS (p=0.043), and gemistocytic astrocytoma had a poor PFS (p=0.004). Younger age and non-eloquent area showed an improved OS (p=0.002 and 0.041), and astrocytic pathology showed a poor OS (p=0.01). Malignant transformation was pathologically diagnosed in 13 out of 86 patients (15%). Gemistocytic astrocytoma correlated independently with malignant transformation (p=0.022).
In LGGs, extent of removal associated with tumor progression. The pathology of astrocytoma, especially gemistocytic astrocytoma, was an independent prognostic factor for recurrence and malignant transformation.
低级别胶质瘤（LGGs）是具有生长缓慢特征的浸润性肿瘤。然而，在早期早期，LGGs会进展并转变为恶性病理状态。我们分析了LGGs进展和恶性转化的预后因素。
2000年至2009年，我们对86例患者进行了手术：42例少突胶质细胞瘤、12例少突星形细胞瘤和32例星形细胞瘤。男女比例为47:39，中位年龄为41（±17.4）岁。平均随访期为4.25（±2.8）年。我们分析了无进展生存期（PFS）、总生存期（OS）和恶性转化的预后因素，考虑了年龄、性别、KPS、临床表现、肿瘤位置、放射学模式、切除范围、病理亚型和辅助治疗。
单因素分析中，非功能区位置、全切和少突胶质细胞病理与改善的PFS和OS在统计学上相关。多因素分析中，全切与更长的PFS相关（p = 0.043），肥胖型星形细胞瘤的PFS较差（p = 0.004）。年龄较小和非功能区显示OS改善（p = 0.002和0.041），星形细胞病理显示OS较差（p = 0.01）。86例患者中有13例（15%）经病理诊断为恶性转化。肥胖型星形细胞瘤与恶性转化独立相关（p = 0.022）。
在LGGs中，切除范围与肿瘤进展相关。星形细胞瘤的病理，尤其是肥胖型星形细胞瘤，是复发和恶性转化的独立预后因素。
