Velocity of tumor spontaneous expansion predicts long-term outcomes for diffuse low-grade gliomas

• DOI: 10.1093/neuonc/nos331
• Publication Date: 2013-02-08T06:17:07Z
• Authors: Johan Pallud; Marie Blonski; Emmanuel Mandonnet; Etienne Audureau; Denys Fontaine; Nader Sanai; Luc Bauchet; Philippe Peruzzi; Marc Frénay; Philippe Colin; Rémy Guillevin; Valérie Bernier; Marie-Hélène Baron; Jacques Guyotat; Hugues Duffau; Luc Taillandier; Laurent Capelle
• Keywords: Adult; Male; Adolescent; Brain Neoplasms; Glioma; Middle Aged; Prognosis; Tumor Burden; 3. Good health; Survival Rate; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Neoplasm Grading; Neoplasm Recurrence, Local; Aged; Follow-Up Studies

Supratentorial diffuse low-grade gliomas present a slow macroscopic tumor growth that can be quantified through the measurement of their velocity diametric expansion. We assessed whether spontaneous expansion predict long-term outcomes as categorical variable and continuous predictor.A total 407 adult patients with newly diagnosed supratentorial in adults were studied.The mean before first-line treatment was 5.8 ± 6.3 mm/year. During follow-up (mean, 86.5 59.4 months), 209 presented malignant transformation, 87 died. The progression-free survival overall significantly longer cases (median, 103 249 months, respectively) than fast 35 91 respectively; P < .001). In multivariate analyses, (<4, ≥4 <8, ≥8 <12, ≥12 mm/year) an independent prognostic factor for (P .001; hazard ratio, 3.87; 95% confidence interval [CI], 2.67-5.52) 4.62; CI, 2.58-7.97). Velocity also predictor, showing linear relationship between (hazard 1.09 per one unit increase; 1.06-1.12; .001).Independent molecular status, allows identification rapidly growing (at higher risk worsened evolution) during pretherapeutic period without delaying treatment.