Department of Neuro-Oncology, East Group Hospital, Hospices Civils de Lyon, Lyon, France.
Department of Clinical Investigation Centre (CIC-1431), Inserm, University Hospital, Besançon, France.
Oncologist. 2022 May 6;27(5):414-423. doi: 10.1093/oncolo/oyac023.
Anaplastic oligodendrogliomas IDH-mutant and 1p/19q codeleted (AO) occasionally have a poor outcome. Herein we aimed at analyzing their characteristics.
We retrospectively analyzed the characteristics of 44 AO patients with a cancer-specific survival <5 years (short-term survivors, STS) and compared them with those of 146 AO patients with a survival ≥5 years (classical survivors, CS) included in the POLA network.
Compared to CS, STS were older (P = .0001), less frequently presented with isolated seizures (P < .0001), more frequently presented with cognitive dysfunction (P < .0001), had larger tumors (P = .= .003), a higher proliferative index (P = .= .0003), and a higher number of chromosomal arm abnormalities (P = .= .02). Regarding treatment, STS less frequently underwent a surgical resection than CS (P = .= .0001) and were more frequently treated with chemotherapy alone (P = .= .009) or with radiotherapy plus temozolomide (P = .= .05). Characteristics independently associated with STS in multivariate analysis were cognitive dysfunction, a number of mitosis > 8, and the absence of tumor resection. Based on cognitive dysfunction, type of surgery, and number of mitosis, patients could be classified into groups of standard (18%) and high (62%) risk of <5 year survival.
The present study suggests that although STS poor outcome appears to largely result from a more advanced disease at diagnosis, surgical resection may be particularly important in this population.
伴 IDH 突变和 1p/19q 共缺失的间变性少突胶质细胞瘤（AO）偶有预后不良者。在此，我们旨在分析其特征。
我们回顾性分析了 44 例癌症特异性生存时间＜5 年（短期幸存者，STS）的 AO 患者的特征，并与纳入 POLA 网络的 146 例生存时间≥5 年（经典幸存者，CS）的 AO 患者进行了比较。
与 CS 相比，STS 患者年龄更大（P＝.0001），更少见单纯性癫痫发作（P＜.0001），更常出现认知功能障碍（P＜.0001），肿瘤更大（P＝.003），增殖指数更高（P＝.0003），染色体臂异常数目更多（P＝.02）。在治疗方面，STS 患者较 CS 更少见行手术切除（P＝.0001），更常单独接受化疗（P＝.009）或接受放化疗（P＝.05）。多变量分析显示，与 STS 相关的独立特征为认知功能障碍、有丝分裂数＞8 个以及肿瘤未切除。基于认知功能障碍、手术类型和有丝分裂数，患者可被分为标准（18%）和高（62%）风险组，其 5 年生存率＜5 年的风险较高。
本研究表明，尽管 STS 预后不良似乎主要是由于诊断时疾病更晚期所致，但手术切除在该人群中可能尤为重要。
