gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Retrospective analysis of a cohort of patients with oligodendroglial brain tumors for outcome and prognosis

Retrospektive Analyse einer Patientenkohorte mit oligodendroglialen Hirntumoren hinsichtlich des Verlaufes und der Prognose

Meeting Abstract

  • corresponding author J. Vesper - ,Abt. Stereotaktische Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg
  • E. Graf - Zentrum Klinische Studien, Universitätsklinikum Freiburg
  • J. Tilgner - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • M. Trippel - ,Abt. Stereotaktische Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg
  • C. Wille - ,Abt. Stereotaktische Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg
  • G. Nikkhah - ,Abt. Stereotaktische Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg
  • C. B. Ostertag - ,Abt. Stereotaktische Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocFR.04.02

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc086.shtml

Veröffentlicht: 11. April 2007

© 2007 Vesper et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The primary objective was a retrospective comparison of progression-free survival (PFS) after a PCV chemotherapy versus a PC chemotherapy following the Freiburg regimen (without vincristine to avoid side effects). Adjustments were made for age, presence of previous malignancy, histologic type and grade and Karnofsky performance score. PFS after resection and after seed implantation were studied descriptively. In addition, overall survival (OS) from first diagnosis of oligodendroglioma or oligoastrocytoma was explored in relation to prognostic factors.

Methods: Patients were retrospectively identified from an MS-ACCESS database containing our consecutive patients with oligodendroglial tumors, treated between 1990 and 2003. For the selected cases, all histopathological statements on specimens taken at the department were re-evaluated by a local neuropathologist according to current standards. Using the updated histology reviews, patients were included in the study if there was at least one histological diagnosis of an oligodendroglial tumor, i.e. oligodendroglioma WHO II° and III°, or oligoastrocytoma WHO II° and III°.

Results: After reevaluation of histological findings in 315 patients oligodendroglial tumors could be determined, of whom 145 underwent either PCV or PC chemotherapy (61 PCV and 84 PC). Patients were devided in two age groups (<50y, ≥50y). Histological grading was similar in both groups (PC and PCV). There were no significant differences in initial Karnofsky-Performance score (KPS). Regarding the PFS there were no differences between PC and PCV (p=0.346). Patients with an initial age of <50y had a significant longer PFS as the elderly ones (P=0.051). Previous resection led to a shorter PFS (p=0.047). There were no differences between oligoastrocytomas and oligodendrogliomas (p=0.487). Significant advantages for patients <50y could be found regarding OS (p<0.001). This was found also for oligoastrocytomas vs. oligodendrogliomas (p=0.002) as well as for WHO grading II° vs. III/IV° (p<0.001). Three different risk groups regarding OS were identified.

Conclusions: While avoiding the major risks of vincristine application, PC is as effective as PCV chemotherapy. Younger age, lower grading and histology of an oligodendroglioma were found as beneficial prognostic factors. Further study is planned regarding a direct comparison of the PC regimen vs. temozolomide with respect to molecular changes.