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间变性少突胶质细胞瘤短期存活者的特征:POLA 网络研究。

Characteristics of Anaplastic Oligodendrogliomas Short-Term Survivors: A POLA Network Study.

机构信息

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.

出版信息

Oncologist. 2022 May 6;27(5):414-423. doi: 10.1093/oncolo/oyac023.

Abstract

BACKGROUND

Anaplastic oligodendrogliomas IDH-mutant and 1p/19q codeleted (AO) occasionally have a poor outcome. Herein we aimed at analyzing their characteristics.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45c8/9074983/72f3101d9729/oyac023f0001.jpg

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