Prognostic
Factors in Oligodendroglioma
D.
Schiffer, A. Dutto, P. Cavalla, I. Bosone, A. Chiò,
R. Villani and C. Bellotti
Abstract:
Background: A reliable marker for tumor oligodendroglial
cells is not yet available, so that the histological recognition
of the tumor still encounters uncertainties. There is no general
agreement also on prognostic factors in oligodendroglioma.
The inconsistency concerns mainly the histopathological factors.
The aim of the study was recognition of prognostic factors
in oligodendroglioma. Methods: In a series of
ninety-eight oligodendrogliomas, including twenty mixed oligoastrocytomas,
clinical [sex, age at surgery, tumor location, symptoms
at presentation], therapeutic [extent of resection,
year of surgery, post-operative Karnofsky score, post-operative
radiotherapy, post-operative chemotherapy], histological
[cell density, nuclear pleomorphism, vascular endothelial
proliferation, necrosis, microcysts, mitoses, mitotic index
(MI), apoptosis, apoptotic index (AI)] and immunohistochemical
parameters [MIB-1 and PCNA Labeling Indexes (LIs), staining
for GFAP, positivity for p53] were correlated with survival
in uni- and multivariate analysis in order to identify their
prognostic significance. Results: Age at surgery,
extent of surgical resection, year of surgery, post-operative
Karnofsky score and MIB-1 LI were associated with survival
in both uni- and multivariate analysis. Location, symptoms
at presentation, mitoses, MI, AI, and PCNA LI showed a significant
correlation with survival in uni- but not in multivariate
analysis. The twenty cases of oligoastrocytomas did not show
any difference in survival from pure oligodendrogliomas. Conclusions:
Some clinical and therapeutic factors together with
MIB-1 LI play a prognostic role. MIB-1 LI is prognostic with
a cut-off of 8%. Histology gives a limited contribution to
the prognosis. Oligoastrocytomas had the same outcome and
prognostic factors as pure oligodendrogliomas.
|
Can.
J. Neurol. Sci. 1997; 24: 313-319
|