Malignant Transformation of Hemispheric Low-Grade Gliomas : Clinical Analysis and Prognostic Factors

뇌반구에 위치한 양성신경교종의 악성전환에 대한 임상적 연구

  • Cho, Keun-Tae (Department of Neurosurgery, Seoul National University, College of Medicine) ;
  • Gwak, Ho-Shin (Department of Neurosurgery, Seoul National University, College of Medicine) ;
  • Jung, Hee-Won (Department of Neurosurgery, Seoul National University, College of Medicine) ;
  • Paek, Sun-Ha (Department of Neurosurgery, Seoul National University, College of Medicine) ;
  • Chung, Young Seob (Department of Neurosurgery, Seoul National University, College of Medicine) ;
  • Kim, Dong Gyu (Department of Neurosurgery, Seoul National University, College of Medicine) ;
  • Cho, Byung Kyu (Department of Neurosurgery, Seoul National University, College of Medicine)
  • 조근태 (서울대학교 의과대학 신경외과학교실) ;
  • 곽호신 (서울대학교 의과대학 신경외과학교실) ;
  • 정희원 (서울대학교 의과대학 신경외과학교실) ;
  • 백선하 (서울대학교 의과대학 신경외과학교실) ;
  • 정영섭 (서울대학교 의과대학 신경외과학교실) ;
  • 김동규 (서울대학교 의과대학 신경외과학교실) ;
  • 조병규 (서울대학교 의과대학 신경외과학교실)
  • Received : 2000.03.09
  • Accepted : 2001.06.25
  • Published : 2001.07.28

Abstract

Introduction : It has been reported that the survival of low-grade glioma patients depends upon the time of malignant transformation. The authors presents the clinical analysis of histologically proven trasformed gliomas. Materials and Method : A total 92 patients who were consecutively treated and histologically confirmed hemispheric low-grade gliomas between 1980 and 1998 were analyzed and followed. All cases meet the criteria of WHO glioma classification of grade II. Results : The mean follow-up period was 73 months. Twenty two among 92 cases(24%) were histologically proven to be transformed into malignant ones. The mean time to transformation was 56 months. The 5-year and 10-year survival rates of the transformed group were 66% and 30% respectively and significantly different from the survival rates of the non-transformed group(p=0.0018). Among clinical factors at presentation, the initial tumor volume had a tendency to be larger in the transformed group than that of the non-transformed group and became significant when it was divided into more than $30cm^3$ or not(p=0.02). Among therapeutic factors, the extent of removal had no influence on the rate of malignant transformation. But postoperative radiation therapy were more frequently given to the pre-transformed group than the non-transformed group and the frequency was significantly different(p=0.02). Conclusions : The authors had found that the initial tumor volume and radiation therapy could be clinical prognostic factors for the malignant transformation of low-grade gliomas.

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