Adult Diffuse Low-Grade Gliomas: 35-Year Experience at the Nancy France Neurooncology Unit.

chemotherapy diffuse low-grade glioma prognosis quality of life radiation therapy surgery survival

Journal

Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867

Informations de publication

Date de publication:
2020
Historique:
received: 20 06 2020
accepted: 20 08 2020
entrez: 16 11 2020
pubmed: 17 11 2020
medline: 17 11 2020
Statut: epublish

Résumé

To report survival, spontaneous prognostic factors, and treatment efficacy in a French monocentric cohort of diffuse low-grade glioma (DLGG) patients over 35 years of follow-up. A monocentric retrospective study of 339 patients diagnosed with a new DLGG between 01/01/1982 and 01/01/2017 was created. Inclusion criteria were patient age ≥18 years at diagnosis and histological diagnosis of WHO grade II glioma (according to 1993, 2007, and 2016 WHO classifications). The survival parameters were estimated using the Kaplan-Meier method with a 95% confidence interval. Differences in survival were tested for statistical significance by the log-rank test. Factors were considered significant when A total of 339 patients were included with a median follow-up of 8.7 years. The Kaplan-Meier median overall survival was 15.7 years. At the time of radiological diagnosis, Karnofsky Performance Status score and initial tumor volume were significant independent prognostic factors. Oncological prognostic factors were the extent of resection for patients who underwent surgery and the timing of radiotherapy for those concerned. In this study, patients who had delayed radiotherapy (provided remaining low grade) did not have worse survival compared with patients who had early radiotherapy. The functional capabilities of the patients were preserved enough so that they could remain independent during at least three quarters of the follow-up. This large monocentric series spread over a long time clarifies the effects of different therapeutic strategies and their combination in the management of DLGG.

Sections du résumé

BACKGROUND BACKGROUND
To report survival, spontaneous prognostic factors, and treatment efficacy in a French monocentric cohort of diffuse low-grade glioma (DLGG) patients over 35 years of follow-up.
METHODS METHODS
A monocentric retrospective study of 339 patients diagnosed with a new DLGG between 01/01/1982 and 01/01/2017 was created. Inclusion criteria were patient age ≥18 years at diagnosis and histological diagnosis of WHO grade II glioma (according to 1993, 2007, and 2016 WHO classifications). The survival parameters were estimated using the Kaplan-Meier method with a 95% confidence interval. Differences in survival were tested for statistical significance by the log-rank test. Factors were considered significant when
RESULTS RESULTS
A total of 339 patients were included with a median follow-up of 8.7 years. The Kaplan-Meier median overall survival was 15.7 years. At the time of radiological diagnosis, Karnofsky Performance Status score and initial tumor volume were significant independent prognostic factors. Oncological prognostic factors were the extent of resection for patients who underwent surgery and the timing of radiotherapy for those concerned. In this study, patients who had delayed radiotherapy (provided remaining low grade) did not have worse survival compared with patients who had early radiotherapy. The functional capabilities of the patients were preserved enough so that they could remain independent during at least three quarters of the follow-up.
CONCLUSION CONCLUSIONS
This large monocentric series spread over a long time clarifies the effects of different therapeutic strategies and their combination in the management of DLGG.

Identifiants

pubmed: 33194684
doi: 10.3389/fonc.2020.574679
pmc: PMC7656991
doi:

Types de publication

Journal Article

Langues

eng

Pagination

574679

Informations de copyright

Copyright © 2020 Obara, Blonski, Brzenczek, Mézières, Gaudeau, Pouget, Gauchotte, Verger, Vogin, Moureaux, Duffau, Rech and Taillandier.

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Auteurs

Tiphaine Obara (T)

Centre de Recherche en Automatique Nancy France - UMR 7039 - BioSiS Department, Faculty of Medicine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
Neurology Departement, Neurooncology Unit, CHRU, Nancy, France.

Marie Blonski (M)

Centre de Recherche en Automatique Nancy France - UMR 7039 - BioSiS Department, Faculty of Medicine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
Neurology Departement, Neurooncology Unit, CHRU, Nancy, France.

Cyril Brzenczek (C)

Centre de Recherche en Automatique Nancy France - UMR 7039 - BioSiS Department, Faculty of Medicine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.

Sophie Mézières (S)

Department of Mathematics, Elie Cartan Institute, Nancy, France.
INRIA Biology, Genetics and Statistics, Nancy, France.

Yann Gaudeau (Y)

Centre de Recherche en Automatique Nancy France - UMR 7039 - BioSiS Department, Faculty of Medicine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.

Celso Pouget (C)

Department of Pathology, CHRU, Nancy, France.
Centre de Ressources Biologiques, BB-0033-00035, CHRU Nancy, France.

Guillaume Gauchotte (G)

Department of Pathology, CHRU, Nancy, France.
Centre de Ressources Biologiques, BB-0033-00035, CHRU Nancy, France.

Antoine Verger (A)

Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, France.
IADI, INSERM U1254, Lorraine University, Vandoeuvre-lès-Nancy, France.

Guillaume Vogin (G)

UMR 7365 CNRS, IMoPA Biopole Lorraine University Faculty of Medicine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
Department of Radiation Therapy, Baclese Radiation Therapy Centre, Esch/Alzette, Luxembourg.

Jean-Marie Moureaux (JM)

Centre de Recherche en Automatique Nancy France - UMR 7039 - BioSiS Department, Faculty of Medicine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.

Hugues Duffau (H)

Department of Neurosurgery, Montpellier University Medical Center, Gui de Chauliac Hospital, Montpellier, France.
Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", U1051 Laboratory, National Institute for Health and Medical Research (INSERM), Institute for Neurosciences of Montpellier, Montpellier University Medical Center, Montpellier, France.

Fabien Rech (F)

Department of Neurosurgery, CHRU, Nancy, France.

Luc Taillandier (L)

Centre de Recherche en Automatique Nancy France - UMR 7039 - BioSiS Department, Faculty of Medicine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
Neurology Departement, Neurooncology Unit, CHRU, Nancy, France.

Classifications MeSH