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Journal of Neuro-Oncology

, Volume 80, Issue 1, pp 75–82 | Cite as

The presence of necrosis and/or microvascular proliferation does not influence survival of patients with anaplastic oligodendroglial tumours: review of 98 patients

  • Sarah F. Smith
  • Judy M. Simpson
  • Janice A. Brewer
  • Lali H. S. Sekhon
  • Michael T. Biggs
  • Raymond J. Cook
  • Nicholas S. Little
Clinical–Patient Studies

Abstract

Accurate prognosis for patients with anaplastic oligodendroglial gliomas is increasingly difficult to make. Characterisation of these tumours remains challenging, increasing proportions of oligodendroglial diagnoses in gliomas are reported, and no WHO 2000 grade IV exists for them, so that highly anaplastic tumours can only be grouped with glioblastoma (GBM) or with grade III oligodendroglioma, which have differing clinical behaviour. Longer survival times reported for patients with glioblastoma containing an oligodendroglial element (GBMO) suggest that a grade IV for oligodendroglial tumours might exist.

In patients with anaplastic gliomas containing an oligodendroglial element, we explored whether microvascular proliferation (MVP) and necrosis were associated with shorter survival, sufficient to create a grade IV. Biopsies for 98 patients with anaplastic oligodendroglioma, anaplastic oligoastrocytoma or tumours with an oligodendroglial and GBM element, discharged 1998–2004, were identified from databases at three allied neurosurgery units. Pathology reports were reviewed for the presence of MVP and necrosis. Anaplastic oligoastrocytoma and GBMO were combined to measure the effect of an astrocytic element on survival.

For anaplastic oligodendroglioma patients, median survival time was 24 months, while for anaplastic oligoastrocytoma or GBMO patients, it was 9 months. Age 60 or over (P = 0.006) and astrocytic element (P = 0.01) were the only independent predictors of survival. Patients 60 and over with an astrocytic element had 4.6 times the risk of death of patients under 60 with anaplastic oligodendroglioma.

A grade IV cannot be created using necrosis or MVP since neither feature predicted survival after adjustment for age and an astrocytic element. However age and an astrocytic element were strong predictors of poorer survival in patients with anaplastic oligodendroglial tumours.

Keywords

Glioblastoma Glioblastoma with oligodendroglial element Microvascular proliferation Oligoastrocytoma Oligodendroglioma Prognosis Survival analysis Tumour grading Tumour necrosis 

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Notes

Acknowledgements

The assistance of Drs J. Fryer and C.␣McKenzie, Department of Anatomical Pathology, Royal North Shore Hospital, St. Leonards, NSW Australia is gratefully acknowledged.

This work was funded by a grant from the Andrew Olle Memorial Trust.

References

  1. 1.
    He J, Mokhtari K, Sanson M, Marie Y, Kujas M, Huguet S, Leuraud P, Capelle L, Delattre JY, Poirier J, Hoang-Xuan K (2001) Glioblastomas with an oligodendroglial component: a pathological and molecular study. J Neuropathol Exp Neurol 60:9863–9871Google Scholar
  2. 2.
    Perry A (2001) Oligodendroglial neoplasms: current concepts, misconceptions, and folklore. Adv Anat Pathol 8:4183–4199Google Scholar
  3. 3.
    Cairncross JG, Louis DL(2000): Molecular diagnosis of anaplastic oligodendroglioma subtypes. Neuro-Oncol 254(abstr)Google Scholar
  4. 4.
    Smith SF, Simpson JM, Sekhon L (2005) What progress has been made in surgical management of patients with astrocytoma and oligodendroglioma in Australia over the last two decades? J Clin Neurosci 12:8915–8921CrossRefGoogle Scholar
  5. 5.
    Cairncross JG, Ueki K, Zlatescu MC, Lisle DK, Finkelstein DM, Hammond RR, Silver JS, Stark PC, Macdonald DR, Ino Y, Ramsay DA, Louis DN (1998) Specific genetic predictors of chemotherapeutic response and survival in patients with anaplastic oligodendrogliomas. J Natl Cancer Inst 90:191473–191479CrossRefGoogle Scholar
  6. 6.
    Kleihues P, Cavenee WK (2000) Pathology & Genetics of Tumours of the Nervous System. IARC Press, LyonGoogle Scholar
  7. 7.
    Kraus JA, Wenghoefer M, Schmidt MC, von Deimling A, Berweiler U, Roggendorf W, Diete S, Dietzmann K, Muller B, Heuser K, Reifenberger G, Schlegel U (2000) Long-term survival of glioblastoma multiforme: importance of histopathological reevaluation. J Neurol 247:6455–6460Google Scholar
  8. 8.
    Donahue B, Scott CB, Nelson JS, Rotman M, Murray KJ, Nelson DF, Banker FL, Earle JD, Fischbach JA, Asbell SO, Gaspar LE, Markoe AM, Curran W (1997) Influence of an oligodendroglial component on the survival of patients with anaplastic astrocytomas: a report of radiation therapy oncology group 83–02. Int J Radiat Oncol Biol Phys 38:5911–5914CrossRefGoogle Scholar
  9. 9.
    Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J, Veelken J, Schramm J, Weller M, Wiestler OD, Louis DN, von DA (2002) Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets. Am J Pathol 161:1313–1319Google Scholar
  10. 10.
    Zlatescu MC, TehraniYazdi A, Sasaki H, Megyesi JF, Betensky RA, Louis DN, Cairncross JG (2001) Tumor location and growth pattern correlate with genetic signature in oligodendroglial neoplasms. Cancer Res 61:186713–186715Google Scholar
  11. 11.
    Smith SF, Simpson JM, Sekhon LH (2004) A quarter of a century of neurosurgery: the value of a relational database to document trends in neurosurgical practice of a tertiary referral hospital. J Clin Neurosci 11:131–136CrossRefGoogle Scholar
  12. 12.
    Daumas-Duport C, Scheithauer BW, O’Fallon J, Kelly P (1988) Grading of astrocytomas. Cancer 62:2152–2165PubMedCrossRefGoogle Scholar
  13. 13.
    Microsoft Corporation. Microsoft Office Professional. XP. 2003. Redmond, WA, USA. Ref Type: Computer ProgramGoogle Scholar
  14. 14.
    SAS Institute. SAS system for Windows. [v.8.00]. 1999. Cary, NC, USA. Ref Type: Computer ProgramGoogle Scholar
  15. 15.
    Scheithauer BW (2004) Oligodendroglioma and ‘mixed’ oligoastrocytoma. Pathol Int 54(Suppl.1):S376–S382Google Scholar
  16. 16.
    Daumas-Duport C, Tucker ML, Kolles H, Cervera P, Beuvon F, Varlet P, Udo N, Koziak M, Chodkiewicz JP (1997) Oligodendrogliomas. part II: a new grading system based on morphological and imaging criteria. J Neurooncol 34:161–178Google Scholar
  17. 17.
    Daumas-Duport C, Varlet P, Tucker ML, Beuvon F, Cervera P, Chodkiewicz JP (1997) Oligodendrogliomas. part I: patterns of growth, histological diagnosis, clinical and imaging correlations: a study of 153 cases. J Neurooncol 34:137–159Google Scholar
  18. 18.
    Giannini C, Scheithauer BW, Weaver AL, Burger PC, Kros JM, Mork S, Graeber MB, Bauserman S, Buckner JC, Burton J, Riepe R, Tazelaar HD, Nascimento AG, Crotty T, Keeney GL, Pernicone P, Altermatt H (2001) Oligodendrogliomas: reproducibility and prognostic value of histologic diagnosis and grading. J Neuropathol Exp Neurol 60:3248–3262Google Scholar
  19. 19.
    Mork SJ, Halvorsen TB, Lindegaard KF, Eide GE (1986) Oligodendroglioma. Histologic evaluation and prognosis. J Neuropathol Exp Neurol 45:165–178Google Scholar
  20. 20.
    Smith MT, Ludwig CL, Godfrey AD, Armbrustmacher VW (1983) Grading of oligodendrogliomas. Cancer 52:112107–112114CrossRefGoogle Scholar
  21. 21.
    Ueki K, Nishikawa R, Nakazato Y, Hirose T, Hirato J, Funada N, Fujimaki T, Hojo S, Kubo O, Ide T, Usui M, Ochiai C, Ito S, Takahashi H, Mukasa A, Asai A, Kirino T (2002) Correlation of histology and molecular genetic analysis of 1p, 19q, 10q, TP53, EGFR, CDK4, and CDKN2A in 91 astrocytic and oligodendroglial tumors. Clin Cancer Res 8:1196–1201Google Scholar
  22. 22.
    Kros JM, Troost D, Van Eden CG, van der Werf AJ, Uylings HB (1988) Oligodendroglioma. A comparison of two grading systems. Cancer 61:112251–112259CrossRefGoogle Scholar
  23. 23.
    Burger PC, Rawlings CE, Cox EB, McLendon RE, Schold SC, Jr., Bullard DE (1987) Clinicopathologic correlations in the oligodendroglioma. Cancer 59:71345–71352Google Scholar
  24. 24.
    Schiffer D, Bosone I, Dutto A, Di VN, Chio A (1999) The prognostic role of vessel productive changes and vessel density in oligodendroglioma. J Neurooncol 44:99–107PubMedCrossRefGoogle Scholar
  25. 25.
    Coons SW, Johnson PC, Scheithauer BW, Yates AJ, Pearl DK (1997) Improving diagnostic accuracy and interobserver concordance in the classification and grading of primary gliomas. Cancer 79:71381–71393CrossRefGoogle Scholar
  26. 26.
    Kleihues P, Louis DN, Scheithauer BW, Rorke LB, Reifenberger G, Burger PC, Cavenee WK (2002) The WHO classification of tumors of the nervous system. J Neuropathol Exp Neurol 61:3215–3225Google Scholar
  27. 27.
    Kros JM, Van Eden CG, Stefanko SZ, Waayer-Van Batenburg M, van der Kwast TH (1990) Prognostic implications of glial fibrillary acidic protein containing cell types in oligodendrogliomas. Cancer 66:61204–61212CrossRefGoogle Scholar
  28. 28.
    Fortin D, Cairncross GJ, Hammond RR (1999) Oligodendroglioma: an appraisal of recent data pertaining to diagnosis and treatment. Neurosurgery 45:61279–61291Google Scholar
  29. 29.
    Godfraind C, Rousseau E, Ruchoux MM, Scaravilli F, Vikkula M (2003) Tumour necrosis and microvascular proliferation are associated with 9p deletion and CDKN2A alterations in 1p/19q-deleted oligodendrogliomas. Neuropathol Appl Neurobiol 29:5462–5471CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Sarah F. Smith
    • 1
  • Judy M. Simpson
    • 2
  • Janice A. Brewer
    • 3
  • Lali H. S. Sekhon
    • 1
  • Michael T. Biggs
    • 1
  • Raymond J. Cook
    • 1
  • Nicholas S. Little
    • 1
  1. 1.Department of NeurosurgeryRoyal North Shore HospitalSt. LeonardsAustralia
  2. 2.School of Public HealthUniversity of SydneySt. LeonardsAustralia
  3. 3.Department of Anatomical PathologyRoyal North Shore HospitalSt. LeonardsAustralia

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