Wang Long, Li Xuegang, Chen Tunan, Zhang Chao, Shi Jiantao, Feng Hua, Li Fei
Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
Chin Neurosurg J. 2022 Oct 1;8(1):25. doi: 10.1186/s41016-022-00295-z.
To explore the risk factors for early progression of diffuse low-grade glioma in adults.
A retrospective analysis of pathologic and clinical data of patients diagnosed with diffuse low-grade gliomas at Southwest Hospital between January 2010 and December 2014. The progression-free survival (PFS) less than 60 months was classified as the early progress group, and the PFS greater than 60 months was the control group for comparative analysis.
A total of 138 patients were included in this study, including 94 cases of astrocytoma and 44 cases of oligodendroglioma. There were 63 cases with 100% resection, 56 cases with 90-100% resection degree, and 19 cases with resection degree < 90%. The average follow-up time was 60 months, of which 80 patients progressed and 58 patients did not progress. The average progression-free survival was 61 months. The median progression-free survival was 60 months. There were 68 patients with PFS ≤ 60 months and 70 patients with PFS > 60 months. The two groups were compared for statistical analysis. In univariate analysis, there were significant differences in tumor subtype (p = 0.005), range (p = 0.011), volume (p = 0.005), location (p = 0.000), and extent of resection (p = 0.000). Multifactor analysis shows tumor location (HR = 4.549, 95% CI: 1.324-15.634, p = 0.016) and tumor subtype (HR = 3.347, 95% CI = 1.373-8.157, p = 0.008), and imcomplete resection is factors influencing early progression of low-grade glioma.
Low-grade gliomas involving deep location such as basal ganglia, inner capsule, and corpus callosum are more likely to progress early, while incomplete resection is a risk factor in early progression of astrocytoma.
探讨成人弥漫性低级别胶质瘤早期进展的危险因素。
回顾性分析2010年1月至2014年12月在西南医院诊断为弥漫性低级别胶质瘤患者的病理和临床资料。无进展生存期(PFS)小于60个月者归为早期进展组,PFS大于60个月者为对照组进行对比分析。
本研究共纳入138例患者,其中星形细胞瘤94例,少突胶质细胞瘤44例。全切100%者63例,切除程度90%-100%者56例,切除程度<90%者19例。平均随访时间60个月,其中80例进展,58例未进展。平均无进展生存期61个月,无进展生存期的中位数为60个月。PFS≤60个月者68例,PFS>60个月者70例。两组进行统计学分析。单因素分析显示,肿瘤亚型(p = 0.005)、范围(p = 0.011)、体积(p = 0.005)、位置(p = 0.000)及切除范围(p = 0.000)存在显著差异。多因素分析显示肿瘤位置(HR = 4.549,95%CI:1.324-15.634,p = 0.016)、肿瘤亚型(HR = 3.347,95%CI = 1.373-8.157,p = 0.008)及切除不完整是影响低级别胶质瘤早期进展的因素。
累及基底节、内囊及胼胝体等深部位置的低级别胶质瘤更易早期进展,而切除不完整是星形细胞瘤早期进展的危险因素。