Department of Neurosurgery, Zhongshan Hospital Xiamen University, Xiamen, China.
Department of Child Health, Women and Children's Hospital, Xiamen University, Xiamen, China.
Cancer Med. 2021 Jan;10(1):416-423. doi: 10.1002/cam4.3577. Epub 2020 Oct 27.
Low-grade gangliogliomas (GGs) are rare tumors of the central nervous system in adults. This study aims to define their characteristics, prognostic factors, and the impact of different treatment patterns on survival.
The Surveillance, Epidemiology, and End Results (SEER) database was used to investigate the potential clinicopathological factors of low-grade GGs in adult patients (age ≥18 years). Kaplan-Meier method and Cox regression model were utilized to evaluate the associations between variables and overall survival (OS).
A total of 703 adult patients diagnosed with low-grade GGs were identified between 2004 and 2016, with a median follow-up period of 60.0 months. The median age at diagnosis was 32.0 years, with 50.1% of patients being male, 84.2% white people, and 40.2% of married status. The predominant tumor site was located in temporal lobe (38.8%). The median OS time for the whole cohort was not reached. The 5- and 10-year OS rates for patients underwent gross total resection (GTR) were 92.5% and 87.2%, respectively. Univariate and multivariate analysis showed age, gender, tumor site, and treatment pattern were significant factors for OS. The employment of adjuvant radiotherapy (RT) and/or chemotherapy would significantly shorten OS time.
This is the largest retrospective study of adult low-grade GGs up to date. Younger age, female gender, temporal lobe location, and GTR indicated better survival. Adjuvant RT and/or chemotherapy should not be considered after whatever surgery in adult patients with low-grade GGs, unless the malignant transformation has been confirmed.
低级神经节细胞瘤(GGs)是成人中枢神经系统罕见的肿瘤。本研究旨在确定其特征、预后因素以及不同治疗模式对生存的影响。
使用监测、流行病学和最终结果(SEER)数据库调查成人(年龄≥18 岁)低级别 GGs 患者的潜在临床病理因素。Kaplan-Meier 法和 Cox 回归模型用于评估变量与总生存期(OS)之间的相关性。
在 2004 年至 2016 年期间,共确定了 703 例成人低级别 GGs 患者,中位随访时间为 60.0 个月。诊断时的中位年龄为 32.0 岁,50.1%为男性,84.2%为白人,40.2%为已婚状态。主要肿瘤部位位于颞叶(38.8%)。全队列的中位 OS 时间未达到。行大体全切除(GTR)的患者 5 年和 10 年 OS 率分别为 92.5%和 87.2%。单因素和多因素分析表明,年龄、性别、肿瘤部位和治疗方式是 OS 的显著因素。辅助放疗(RT)和/或化疗的应用显著缩短了 OS 时间。
这是迄今为止最大的关于成人低级别 GGs 的回顾性研究。年轻、女性、颞叶位置和 GTR 提示更好的生存。除非已经确认恶性转化,否则在成人低级别 GGs 患者中,无论手术如何,都不应考虑辅助 RT 和/或化疗。