PMID- 17135643
OWN - NLM
STAT- MEDLINE
DCOM- 20061215
LR  - 20220316
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Linking)
VI  - 24
IP  - 34
DP  - 2006 Dec 1
TI  - Significance of necrosis in grading of oligodendroglial neoplasms: a 
      clinicopathologic and genetic study of newly diagnosed high-grade gliomas.
PG  - 5419-26
AB  - PURPOSE: High-grade gliomas (HGGs; WHO grades 3-4) are highly diverse, with 
      survival times ranging from months to years. WHO 2000 grading criteria for 
      high-grade oligodendroglial neoplasms [anaplastic oligoastrocytoma (AOA) and 
      anaplastic oligodendroglioma (AO)] remain subjective, and the existence of grade 
      4 variants is controversial. PATIENTS AND METHODS: Overall survival (OS) of 1,093 
      adult patients with a cerebral HGG newly diagnosed between 1990 and 2005 was 
      analyzed by univariate and multivariate models for significance of the following 
      factors: patient age, surgery type, year of diagnosis, endothelial proliferation, 
      necrosis, oligodendroglial histology, treatment center, and chromosome 1p, 19q, 
      7p (EGFR), and 10q (PTEN) abnormalities by fluorescence in situ hybridization 
      (FISH). RESULTS: Necrosis was a statistically significant predictor of poor OS on 
      univariate and multivariate analyses in AOA but not in AO. Median OS for patients 
      with necrotic AOA (22.8 months) was significantly worse than for patients with 
      non-necrotic AOA (86.9 months; P < .0001) but was better than conventional 
      glioblastomas (9.8 months; P < .0001). In addition to patient age, the following 
      were significant independent prognostic factors (P .001): grade and surgery type 
      for the entire HGG cohort; modified grade for AOA (3 v 4); and modified grade, 
      1p/19q codeletion status, and oligodendroglial histology for the 586 HGGs 
      analyzed by FISH. CONCLUSION: Stratification of AOA, but not of pure AO, into 
      grades 3 and 4 on the basis of necrosis is prognostically justified and is more 
      powerful than the current approach. Both routine histology and genetic testing 
      provide independent, prognostically useful information.
FAU - Miller, C Ryan
AU  - Miller CR
AD  - Division of Neuropathology, Washington University School of Medicine, St Louis, 
      MO 63110, USA.
FAU - Dunham, Christopher P
AU  - Dunham CP
FAU - Scheithauer, Bernd W
AU  - Scheithauer BW
FAU - Perry, Arie
AU  - Perry A
LA  - eng
GR  - T32CA009547/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
MH  - Adult
MH  - Brain Neoplasms/*genetics/mortality/*pathology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Models, Statistical
MH  - Multivariate Analysis
MH  - Necrosis
MH  - Oligodendroglioma/*genetics/mortality/*pathology
MH  - Prognosis
MH  - Survival Analysis
EDAT- 2006/12/01 09:00
MHDA- 2006/12/16 09:00
CRDT- 2006/12/01 09:00
PHST- 2006/12/01 09:00 [pubmed]
PHST- 2006/12/16 09:00 [medline]
PHST- 2006/12/01 09:00 [entrez]
AID - 24/34/5419 [pii]
AID - 10.1200/JCO.2006.08.1497 [doi]
PST - ppublish
SO  - J Clin Oncol. 2006 Dec 1;24(34):5419-26. doi: 10.1200/JCO.2006.08.1497.