Survival, prognostic factors, and therapeutic efficacy in low-grade glioma: a retrospective study in 379 patients.

1997 ◽  
Vol 15 (9) ◽  
pp. 3129-3140 ◽  
Author(s):  
K Lote ◽  
T Egeland ◽  
B Hager ◽  
B Stenwig ◽  
K Skullerud ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Median Survival ◽  
Tumor Resection ◽  
Low Grade Glioma ◽  
World Health ◽  
Symptom Duration ◽  
Low Grade ◽  
Age Group ◽  
Patient Age ◽  
Patient Âgé

PURPOSE We report survival, prognostic factors, and treatment efficacy in low-grade glioma. PATIENTS AND METHODS A total of 379 patients with histologic intracranial low-grade glioma received post-operative radiotherapy (n = 361) and intraarterial carmustine (BCNU) chemotherapy (n = 153). Overall survival and prognostic factors were evaluated with the SPSS statistical program (SPSS Inc, Chicago, IL). RESULTS Median survival (all patients) was 100 months (95% confidence interval [CI], B7 to 113); in age group 0 to 19 years (n = 41), 226 months; in age group 20 to 49 years (n = 263), 106 months; in age group 50 to 59 years (n = 49), 76 months; and for older patients (n = 26), 39 months. Projected survival at 10 and 15 years was 42% and 29%, respectively. Patient age, World Health Organization (WHO) performance status, tumor computed tomography (CT) contrast enhancement, mental changes, or initial corticosteroid dependency were significant independent prognostic factors (p < .05), while histologic subgroup, focal deficits, presence of seizures, prediagnostic symptom duration, tumor category, and tumor stage were not. Patients aged 20 to 49 years with no independent negative prognostic factors (n = 132) had a median survival time of 139 months versus 41 months in patients with two or more factors (n = 33). Patients who presented with symptoms of expansion (n = 97) survived longer when resected (P < .03); otherwise no survival benefit was associated with initial tumor resection compared with biopsy. Intraarterial chemotherapy and radiation doses more than 55 Gy were not associated with prolonged survival. Among 66 reoperated patients, 45% progressed to high-grade histology within 25 months. CONCLUSION Prognosis in low-grade glioma following postoperative radiotherapy seems largely determined by the inherent biology of the glioma and patient age at diagnosis.

scholarly journals Early CT features of COVID-19 pneumonia, association with patients’ age and duration of presenting complaint

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Reem M. EL Kady ◽  
Hosam A. Hassan ◽  
Tareef S. Daqqaq ◽  
Rania Makboul ◽  
Hanan Mosleh Ibrahim
Keyword(s):  
Pleural Effusion ◽  
Ground Glass Opacity ◽  
Ct Imaging ◽  
Older Age ◽  
Ground Glass ◽  
Imaging Features ◽  
Age Group ◽  
Patient Age ◽  
Atypical Features ◽  
Patient Âgé

Abstract Background Coronavirus disease (COVID-19) is a respiratory syndrome with a variable degree of severity. Imaging is a vital component of disease monitoring and follow-up in coronavirus pulmonary syndromes. The study of temporal changes of CT findings of COVID-19 pneumonia can help in better understanding of disease pathogenesis and prediction of disease prognosis. In this study, we aim to determine the typical and atypical CT imaging features of COVID-19 and discuss the association of typical CT imaging features with the duration of the presenting complaint and patients’ age. Results The lesions showed unilateral distribution in 20% of cases and bilateral distribution in 80% of cases. The lesions involved the lower lung lobes in 30% of cases and showed diffuse involvement in 58.2% of cases. The lesions showed peripheral distribution in 74.5% of cases. The most common pattern was multifocal ground glass opacity found in 72.7% of cases. Atypical features like cavitation and pleural effusion can occur early in the disease course. There was significant association between increased number of the lesions, bilaterality, diffuse pattern of lung involvement and older age group (≥ 50 years old) and increased duration of presenting complaint (≥ 4 days). There was significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age. Conclusion The most common CT feature of COVID-19 was multifocal ground glass opacity. Atypical features like cavitation and pleural effusion can occur early in the course of the disease. Our cases showed more extensive lesions with bilateral and diffuse patterns of distribution in the older age group and with increased duration of presenting complaint. There was a significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age.

TMPRSS2-ERG Fusions Are Strongly Linked to Young Patient Age in Low-grade Prostate Cancer

2014 ◽  
Vol 66 (6) ◽  
pp. 978-981 ◽  
Author(s):  
Stefan Steurer ◽  
Pascale Sophia Mayer ◽  
Meike Adam ◽  
Antje Krohn ◽  
Christina Koop ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Young Patient ◽  
Low Grade ◽  
Patient Age ◽  
Patient Âgé

Left Pan-Hippocampal Low Grade Glioma—2-Stage Transsylvian Transventricular and Paramedian Supracerebellar Transtentorial Approaches: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (3) ◽  
pp. E82-E82
Author(s):  
Juan C Fernandez-Miranda
Keyword(s):  
Tumor Resection ◽  
Spatial Relationship ◽  
Low Grade Glioma ◽  
Parahippocampal Gyrus ◽  
Surgical Approaches ◽  
Low Grade ◽  
Fiber Tractography ◽  
High Definition ◽  
Posterior Portion ◽  
Fiber Tracts

Abstract The surgical goal for low-grade gliomas (LGGs) is to maximize resection while minimizing morbidity. Pan-hippocampal LGGs extend from the hippocampal head to the hippocampal tail, and involve the parahippocampal gyrus and uncus. Given their anteroposterior extension, they cannot be completely removed with 1 single approach, requiring a 2-stage front-to-back operation.  In this video, we present the case of a 52-yr-old man with new onset of generalized seizures and a dominant-side, nonenhancing, pan-hippocampal infiltrative lesion compatible with a low-grade glioma. Preoperative high-definition fiber tractography (HDFT) showed the spatial relationship of the tumor with surrounding fiber tracts, such as the arcuate, inferior fronto-occipital, and middle longitudinal fascicles, and optic radiations.  Surgical resection was planned in 2 separate stages. The first stage consisted of a transsylvian transinferior insular sulcus approach to the extra- and intraventricular aspects of the uncohippocampal region. The entire anterior and middle portions of the tumor were successfully removed with minimal morbidity, including transient naming difficulties and permanent superior quadrantanopia. Postoperative HDFT showed preservation of all fiber tracts, except for a portion of Meyer's loop and the inferior-most aspect of the inferior fronto-occipital fascicle. The second stage was completed 8 wk later and consisted of a paramedian supracerebellar-transtentorial approach on sitting position. The posterior portion of the tumor was entirely removed to achieve a complete macroscopic tumor resection. The final diagnosis was IDH1-positive LGG.  Pan-hippocampal tumors remain a surgical challenge but accurate knowledge of surgical neuroanatomy and surgical approaches facilitates their safe and effective treatment.  The patient signed an informed consent including the use of photographic and video material for educational or academic purposes.

scholarly journals Management of low-grade glioma: a systematic review and meta-analysis

2018 ◽  
Vol 6 (4) ◽  
pp. 249-258 ◽  
Author(s):  
Timothy J Brown ◽  
Daniela A Bota ◽  
Martin J van Den Bent ◽  
Paul D Brown ◽  
Elizabeth Maher ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Low Grade Glioma ◽  
World Health ◽  
Subtotal Resection ◽  
Low Grade ◽  
Evidence Based ◽  
Free Survival ◽  
Low Grade Gliomas

Abstract Background Optimum management of low-grade gliomas remains controversial, and widespread practice variation exists. This evidence-based meta-analysis evaluates the association of extent of resection, radiation, and chemotherapy with mortality and progression-free survival at 2, 5, and 10 years in patients with low-grade glioma. Methods A quantitative systematic review was performed. Inclusion criteria included controlled trials of newly diagnosed low-grade (World Health Organization Grades I and II) gliomas in adults. Eligible studies were identified, assigned a level of evidence for every endpoint considered, and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality and of progression at 2, 5, and 10 years was calculated for patients undergoing resection (gross total, subtotal, or biopsy), radiation, or chemotherapy. Results Gross total resection was significantly associated with decreased mortality and likelihood of progression at all time points compared to subtotal resection. Early radiation was not associated with decreased mortality; however, progression-free survival was better at 5 years compared to patients receiving delayed or no radiation. Chemotherapy was associated with decreased mortality at 5 and 10 years in the high-quality literature. Progression-free survival was better at 5 and 10 years compared to patients who did not receive chemotherapy. In patients with isocitrate dehydrogenase 1 gene (IDH1) R132H mutations receiving chemotherapy, progression-free survival was better at 2 and 5 years than in patients with IDH1 wild-type gliomas. Conclusions Results from this review, the first to quantify differences in outcome associated with surgery, radiation, and chemotherapy in patients with low-grade gliomas, can be used to inform evidence-based management and future clinical trials.

scholarly journals RTHP-31. LOW GRADE GLIOMA MALIGNANT TRANSFORMATION (MT): CLINICAL OUTCOMES AND PROGNOSTIC FACTORS IN TEMOZOLOMIDE ERA

2016 ◽  
Vol 18 (suppl_6) ◽  
pp. vi180-vi180 ◽  
Author(s):  
Erin Murphy ◽  
C. Marc Leyrer Leyrer ◽  
Michael Parsons ◽  
John Suh ◽  
Samuel Chao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Clinical Outcomes ◽  
Malignant Transformation ◽  
Low Grade Glioma ◽  
Low Grade

scholarly journals P-097. Patient age and FSH concentration as prognostic factors in IVF outcome

1997 ◽  
Vol 12 (Suppl_2) ◽  
pp. 166-167 ◽  
Author(s):  
P.E. Levi Setti ◽  
A. Vucetich ◽  
P. Sulpizio ◽  
G. Ragusa ◽  
M. Ravizza ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Ivf Outcome ◽  
Patient Age ◽  
Patient Âgé

scholarly journals THE UTILITY OF PGT VS NON-PGT FROZEN EMBRYO TRANSFER BY PATIENT AGE GROUP

2020 ◽  
Vol 114 (3) ◽  
pp. e416-e417
Author(s):  
Christopher Hibray ◽  
Nicole George ◽  
Lynn B. Davis ◽  
Gerard Letterie ◽  
G. David Ball
Keyword(s):  
Embryo Transfer ◽  
Frozen Embryo Transfer ◽  
Age Group ◽  
Patient Age ◽  
Patient Âgé

Supratentorial low-grade glioma in adults: an analysis of prognostic factors and timing of radiation.

1997 ◽  
Vol 15 (4) ◽  
pp. 1294-1301 ◽  
Author(s):  
C Leighton ◽  
B Fisher ◽  
G Bauman ◽  
S Depiero ◽  
L Stitt ◽  
...  
Keyword(s):  
Median Survival ◽  
Karnofsky Performance Status ◽  
Univariate Analysis ◽  
Residual Tumor ◽  
Low Grade Glioma ◽  
Cancer Center ◽  
Entire Group ◽  
Low Grade ◽  
Mixed Glioma ◽  
Modern Imaging

PURPOSE To review the outcomes of patients with low-grade glioma diagnosed by modern imaging and treated at a center where postponing radiotherapy was common practice. METHODS We reviewed the records of patients (age > or = 18 years) with pathologically confirmed supratentorial low-grade fibrillary astrocytoma, oligodendroglioma, and mixed glioma treated at a regional cancer center in Canada between 1979 and 1995. RESULTS Median survival for the entire group (N = 167; mean age 40.6 years) was 10.5 years with 5- and 10-year survival rates of 72% and 50%, respectively. Median progression-free survival was 4.9 years with 5- and 10-year progression-free rates of 50% and 12%, respectively. Overall and progression-free survivals were longer for patients with an oligodendroglioma or mixed glioma than with astrocytoma (median 13 v 7.5 years, P = .003; progression-free 5.6 v 4.4 years, p = .054). Age at diagnosis < or = 40 years, seizures at presentation, minimal residual tumor after surgery, Karnofsky performance status > or = 70, and oligodendroglioma or mixed glioma pathology were associated with significantly longer median survival on univariate and multivariate analyses. Radiotherapy deferred until tumor progression (v immediate radiotherapy) was associated with longer survival on univariate analysis, but an imbalance in other variables accounted for this advantage such that timing of radiotherapy was not an independent (favorable or adverse) prognostic factor on multivariate analysis. CONCLUSION Patients with low-grade glioma diagnosed by modern imaging can be expected to live a long time; timing of radiotherapy may be a less important determinant of survival than nontreatment variables and residual tumor bulk.

Imaging in low-grade glioma: a guide for neurologists

2017 ◽  
Vol 18 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Jennifer Larsen ◽  
Nigel Hoggard ◽  
Fiona M McKevitt
Keyword(s):  
Surgical Planning ◽  
World Health Organisation ◽  
Low Grade Glioma ◽  
World Health ◽  
Low Grade ◽  
The Central Nervous System ◽  
Contemporary Management

The management of low-grade glioma (LGG) is shifting as evidence has emergedthat refutes the previously commonplace imaging-based ‘watch and wait’ approach, in favour of early aggressive surgical resection. This coupled with the recent 2016 update to the World Health Organisation Classification of Tumours of the Central Nervous System is changing LGG imaging and management. Recently in Practical Neurology the contemporary management of low-grade glioma and the changes to this grading system were discussed in detail. 1 In this complementary article, we discuss the role of imaging in the diagnosis, surgical planning and post-treatment follow-up of LGG. We describe the principles of imaging these tumours and use several cases to highlight some difficult scenarios.

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