Survival prognosis and influencing factors of adult patients with lower-grade glioma
Objective To investigate the survival of adult patients with lower grade gliomas(LGGs)and its influencing factors.Methods A retrospective analysis was performed on the clinical data of 156 cases of LGGs admitted to the Department of Neurosurgery of the Second Affiliated Hospital,Army Medical University from March 2015 to September 2021.Among 156 patients,there were 109 cases of WHO grade 2 and 47 cases of WHO grade 3.The clinical characteristics were compared between patients with isocitrate dehydrogenase(IDH)-wild type glioma and patients with IDH-mutant type glioma.Kaplan-Meier curve was drawn,and the survival of the two groups was compared by log-rank test.Univariate and multivariate Cox model analysis were used to determine the independent influencing factors affecting survival.Results The age and proportion of patients having neurological deficits before surgery were significantly different between patients with IDH mutant and wild-type LGGs(both P＜0.05).The Kaplan-Meier curve analysis showed that the 5-year overall survival(OS)and 5-year progression-free survival(PFS)of LGGs was 77.9％and 68.8％,respectively.Log-rank analysis showed that patients older than 42,presence of neurological deficits before surgery,WHO grade 3,astrocytoma,subtotal resection,IDH wild-type and Ki-67 proliferation index greater than 10％predicted worse OS for LGGs(all P＜0.05),while＞42 years old,WHO grade 3,astrocytoma,IDH wild-type and Ki-67 proliferation index greater than 10％predicted worse PFS for LGGs(all P＜0.05).Multivariate Cox risk analysis showed that lower tumor grade(HR=0.30,95％CI:0.09-0.94,P=0.040),gross total resection(HR=0.31,95％CI:0.12-0.79,P=0.015),and IDH mutations(HR=0.24,95％CI:0.10-0.59,P=0.002)were independent protective factors for the OS of LGGs.Lower tumor grade(HR=0.39,95％CI:0.19-0.82,P=0.012)was independent protective factor for PFS of LGGs.Conclusion Gross total resection and lower tumor grade(WHO grade 2)are associated with good prognosis for LGGs,while IDH wild-type LGGs suggests worse prognosis.
GliomaDisease attributesPrognosisLower gradeIsocitrate dehydrogenaseRoot cause analysis
NETL
NSTL
万方数据
