Prognostic factors for gliomas:analysis of 173 cases

LI Jian-feng; CHEN Yin-sheng; SAI Ke; ZHANG Xiang-heng; KE Chao; YANG Qun-ying; MOU Yong-gao; XU Hai-xiong; CHEN Zhong-ping

doi:10.13798/j.issn.1009-153X.2016.06.003

Abstract：Objective To analyze the prognostic factors for patietns with gliomas. Methods The clinical data of 173 patients with pathologically confirmed gliomas at Sun Yat-sen University Cancer Center from January of 2000 to December of 2009 were analyzed retrospectively. Survival was estimated by Kaplan-Meier analysis. The univariateand multivariate analysis of the factors related to the prognosis was performed. Results Among 173 patients, 10 (5.8%) were diagnosed with WHO gradeⅠgliomas, 61 (35.3%) with grade Ⅱgliomas, 53 (30.6%) with grade Ⅲ gliomas and 49 (28.3%) with glioblasto mamultiforme, respectively. Of 98 patients who received postoperative radiotherapy, 61 had high-grade gliomas (WHO gradesⅢandⅣ) and 37 low-grade gliomas (WHO gradesⅠandⅡ), respectively. Of 60 patients who received adjuvant chemotherapy, 46 had high-grade gliomas and 14 low-grade gliomas, respectively. The 1-, 3- and 5-year overall survival of 173 patients was 74.0%, 42.2%and 32.4%, respectively. The 5-year overall survival of the patients with gliomas of WHO grade Ⅰ, Ⅱ, Ⅲ and Ⅳ was 80.0%, 52.5%, 24.5% and 6.1%, respectively. The univariate analysis showed that gender, age, preoperative seizure, histological grade, tumor location (supratentorial or subtentorial) and extent of resection (total or partial) were factors related to the prognosis for patients with gliomas. The stratified analysis by log-rank test revealed that adjuvant radiotherapy was a prognostic factor for patients with high-grade gliomas but not for those with low-grade gliomas. Breslow test indicated that adjuvant chemotherapy was a prognostic factor for patients with high-grade gliomas. The multivariate analysis showed that the prognostic factors included age (≤40 or >40 years), histological grade, the extent of resection and post-operative radiotherapy for glioma patients. Conclusions The results showed that the age ≤40 years, gliomas of lower grade and total resection of tumor were associated with improved overall survival in the patients with gliomas. The patients with high-grade gliomas and the patients with a certain subgroup of low-grade gliomas may benefit from post-operative radiotherapy and adjuvant chemotherapy.