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Journal of Korean Neurosurgical Society 2001;30(7): 855-860.
Malignant Transformation of Hemispheric Low-Grade Gliomas: Clinical Analysis and Prognostic Factors.
Keun Tae Cho, Ho Shin Gwak, Hee Won Jung, Sun Ha Paek, Young Seob Chung, Dong Gyu Kim, Byung Kyu Cho
Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea.
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 METHODS: 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.
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 30cm3 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).
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.
Key Words: Low-grade glioma; Malignant transformation; Tumor volume; Radiation therapy
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