ABSTRACT
This work was supported by Science and Technology Program of Health and Family Planning Commission of Jiangxi Province (No.20161106) Abstract Objective: To investigate the prognostic value of subventricular zone (SVZ) invasion in glioma patients. Methods: The clini-cal data of 175 patients with glioma diagnosed based on pathology in Jiangxi Province Cancer hospital between January 2010 and July 2015 were analyzed retrospectively. There were 59 cases of World Health Organization (WHO) gradeⅡ, 59 cases of WHO gradeⅢ, and 57 cases of WHO gradeⅣat the first diagnosis. There were 75 cases of SVZ invasion (SVZ+) and 100 cases of SVZ non-invasion (SVZ-) according to preoperative magnetic resonance imaging. The survival outcomes of both cohorts were compared using the Log-rank test. The correlation between the recurrence pattern and SVZ involvement was analyzed using Chi-square tests. Results: The me-dian follow-up time was 63 months. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 42.2% and 37.5%, respectively. These were 20.9% and 15.3% in the SVZ+group, compared with 57.1% and 44.1% in the SVZ-group, respectively (P<0.001 and P<0.001, respectively). The SVZ+group had fewer cases of total resection, larger lesions (maximum diameter greater than 5.0 cm), and more cases of gradeⅣ(P<0.001, P<0.001, and P=0.018, respectively). There were 89 cases of recurrence. The total recur-rence rate was 62.7% in the SVZ+group, compared with 42.0% in the SVZ-group (P=0.007); the distant recurrence rates were 21.3% and 7.0% (P=0.004), respectively. Conclusions: SVZ invasion is a poor prognostic factor for OS and PFS in gliomas, which is positively correlated with a low total resection rate, large lesions, and gradeⅣlesions, and increases the probability of total recurrence and dis-tant recurrence.
ABSTRACT
Objective:To assess the prognostic factors of World Health Organization(WHO)grade Ⅱ gliomas.Methods:A total of 146 patients diagnosed with WHO grade Ⅱ gliomas were treated at Jiangxi Province Tumor Hospital between June 1997 and April 2015,in-cluding 90 gross total resections(GTRs)and 56 partial resections.According to the 2007 WHO grading system of gliomas,there were 96 astrocytomas,30 oligodendrogliomas,and 20 oligoastrocytomas.Results:The median follow-up time was 88 months.Five-year overall survival(OS)and progression-free survival(PFS)rates were 75.7% and 60.0%,respectively,and 10-year OS and PFS rates were 57.4% and 37.8%,respectively.Univariate analysis of OS revealed statistically significant differences in age,sex,subventricular zone (SVZ) invasion, peritumoral edema, residual tumor volume, preoperative tumor size and numbers, and the extent of resection (P<0.05). Compared with astrocytoma patients, oligodendroglioma patients had better OS and PFS (P=0.040 and 0.049, respectively). Among those factors,sex,SVZ invasion,residual tumor volume,preoperative tumor numbers,and the extent of resection were like-wise significant for PFS (P<0.05). Multivariate analysis revealed that the extent of resection, SVZ invasion, and peritumoral edema were independent prognostic factors for OS(P<0.05)and the extent of resection and tumor numbers were independent prognostic fac-tors for PFS(P<0.05).Sixty patients developed recurrences,including 53 tumor bed failures and 7 intracranial disseminations.Conclu-sions:The extent of resection,SVZ invasion and peritumoral edema may be independent prognostic factors for OS in low-grade glio-mas.Postoperative radiotherapy would improve PFS for patients who underwent GTRs.The major pattern of failure was tumor bed re-currence.