Prognostic Factors for Survival in Adult Patients With Cerebral Low-Grade Glioma

Prognostic Factors for Survival in Adult Patients With Cerebral Low-Grade Glioma

By Francesco Pignatti, for the European Organization for Research and Treatment of Cancer Brain Tumor Cooperative Group and Radiotherapy Cooperative Group     Journal of Clinical Oncology, Vol 20, Issue 8 (April), 2002: 2076-2084

To identify prognostic factors for survival in adult patients with cerebral low-grade glioma (LGG), to derive a prognostic scoring system, and to validate results using an independent data set. European Organization for Research and Treatment of Cancer (EORTC) trial 22844 and EORTC trial 22845 are the largest phase III trials ever carried out in adult patients with LGG. The trials were designed to investigate the dosage and timing of postoperative radiotherapy in LGG. Cox analysis was performed on 322 patients from EORTC trial 22844 (construction set), and the results were validated on 288 patients from trial 22845 (validation set). Patients with pilocytic astrocytomas were excluded from this prognostic factor analysis.

Multivariate analysis on the construction set showed that age   40 years, astrocytoma histology subtype, largest diameter of the tumor  6 cm, tumor crossing the midline, and presence of neurologic deficit before surgery were unfavorable prognostic factors for survival. The total number of unfavorable factors present can be used to determine the prognostic score.

Presence of up to two of these factors identifies the low-risk group, whereas a higher score identifies high-risk patients. The validity of the multivariate model and of the scoring system was confirmed in the validation set.