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Low-grade oligodendroglioma: an indolent but incurable disease
Journal of Neurosurgery, 08/13/09

El–Hateer H et al. – In a study to examine 1 institution's experience with pure low-grade oligodendroglioma (LGO), correlating outcomes with several variables of possible prognostic values, the indolent but progressively fatal nature of LGOs was confirmed. Contrast enhancement was the most evident single prognostic factor. New treatment strategies are clearly needed in the management of this disease.

Methods

69 pts with WHO-classified LGOs were treated between 1992 and 2006 at the McGill University Health Center.
Clinical, pathological, and radiological records were carefully reviewed.
Demographic characteristics; nature and duration of presenting symptoms; baseline neurological function; extent of resection; Karnofsky Performance Scale score; preoperative radiological findings including tumor size, location, and absence/presence of enhancement; and pathological data including chromosome arms 1p/19q codeletion and O-methylguanine-DNA methyltransferase promoter gene methylation status were all compiled.
Timing and dose of radio- and/or chemotherapy, date of tumor progression, pathological finding at disease progression, treatment at time of disease progression, and status at last follow-up were also recorded.

Results

Median follow-up period was 6.1 yrs.
The majority (78%) of pts presented with seizures; contrast enhancement was initially seen in 16 pts (25%).
All pts had undergone an initial surgical procedure: gross-total resection in 27%, partial resection in 59%, and biopsy only in the remaining 13%.
15 pts received adjuvant radiotherapy.
Data on O-methylguanine-DNA methyltransferase promoter gene methylation status was available in 47 pts (68%) and in all but 1 pt for 1p/19q status.
Survival at 5, 10, and 15 yrs was 83, 63, and 29%, respectively.
Multivariate analysis showed that seizures at presentation and absence of contrast enhancement were the only independent favorable prognostic factors for survival.
5-, 10-, and 15-yr progression-free survival rates were 46, 7.7, and 0%, respectively.

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