Pretreatment factors predict overall survival for patients with low-grade glioma: a recursive partitioning analysis
| Autor: | Larry Stitt, Lukas J.A. Stalpers, William M. Wara, David A. Larson, Glenn Bauman, Knut Lote, Christopher Leighton, David R. Macdonald, Barbara Fisher, J. Gregory Cairncross |
|---|---|
| Přispěvatelé: | Other departments |
| Jazyk: | angličtina |
| Rok vydání: | 1999 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Multivariate analysis Recursive partitioning Sex Factors Glioma Internal medicine Medicine Humans Radiology Nuclear Medicine and imaging Fibrillary astrocytoma Survival analysis Univariate analysis Analysis of Variance Radiation business.industry Age Factors Astrocytoma Supratentorial Neoplasms medicine.disease Prognosis Combined Modality Therapy Survival Analysis Surgery Databases as Topic Female Oligodendroglioma business |
| Zdroj: | International journal of radiation oncology, biology, physics, 45(4), 923-929. Elsevier Inc. |
| ISSN: | 0360-3016 |
| Popis: | Purpose: Three databases were pooled and analyzed to determine which groupings of prognostic factors best predicted overall survival for patients with low-grade gliomas treated with surgery and immediate or delayed radiotherapy. Methods and Materials: Databases of patients with low-grade gliomas compiled at the London Regional Cancer Centre (LRCC), the Norwegian Radium Hospital (NRH), and the University of California, San Francisco (UCSF) were merged. Inclusion criteria for the pooled analysis included: age ≥ 18 years and histologically confirmed low-grade (World Health Organization Grade II) supratentorial fibrillary astrocytoma, oligodendroglioma or mixed oligoastrocytoma. Factors analyzed for prognostic significance included: age at diagnosis, gender, seizures at presentation, presence of enhancement on computed tomography (CT) or magnetic resonance imaging (MRI), Karnofsky Performance Status (KPS) at diagnosis, histology, extent of surgical resection, timing of radiotherapy, and treating institution. Univariate and multivariate analysis of overall survival for these factors was performed. Recursive partitioning was performed to generate prognostic groups using these factors. Results: From the combined databases, 401 patients were eligible for analysis. Median survival for the entire group was 95 months/7.9 years. On univariate analysis age 18–40, presence of seizures at presentation, KPS ≥ 70, treating institution, and absence of contrast enhancement were associated with improved overall survival. On multivariate analysis, these factors remained independent predictors of improved overall survival. Recursive partitioning analysis yielded four prognostic groups with statistically different median survivals (MS): Group I ( n = 41: KPS 40) MS 12 months; Group II ( n = 34: KPS ≥ 70, age > 40, enhancement present) MS 46 months; Group III ( n = 138: KPS 40, no enhancement) MS 87 months; Group IV ( n = 188: KPS ≥ 70, age 18–40) MS 128 months. Conclusion: Clusters of pretreatment prognostic factors described subgroups of low-grade glioma patients with divergent overall survivals. Consideration of these prognostic subgroups may be important when considering timing of interventions for these patients and in the stratification of patients for clinical trials. |
| Databáze: | OpenAIRE |
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