Authors: Yoshikazu Okamoto PierLuigi Di Patre Christoph Burkhard Sonja Horstmann Benjamin Jourde Michael Fahey Danielle Schüler Nicole M ProbstHensch M Gazi Yasargil Yasuhiro Yonekawa Urs M Lütolf Paul Kleihues Hiroko Ohgaki
Publish Date: 2004/04/28
Volume: 108, Issue: 1, Pages: 49-56
Abstract
We carried out a populationbased study on lowgrade diffuse gliomas in the Canton of Zurich Switzerland population 116 million From 1980 to 1994 987 astrocytic and oligodendroglial tumors were diagnosed of which 122 124 were lowgrade WHO grade II The incidence rates adjusted to the World Standard Population per million population per year were 228 for lowgrade diffuse astrocytomas 089 for oligoastrocytomas and 245 for oligodendrogliomas The survival rate mean followup 75±48 years was highest for patients with oligodendroglioma 78 at 5 years 51 at 10 years followed by those with oligoastrocytoma 70 at 5 years 49 at 10 years and fibrillary astrocytoma 65 at 5 years 31 at 10 years Survival of patients with gemistocytic astrocytoma was poor with survival rates of 16 at 5 years and 0 at 10 years Younger patients 50 years survived significantly longer than older patients 50 years P=0013 DNA sequencing performed in 84 of cases revealed that TP53 mutations were most frequent in gemistocytic astrocytomas 88 followed by fibrillary astrocytomas 53 and oligoastrocytomas 44 but were infrequent 13 in oligodendrogliomas The presence of TP53 mutations was associated with shorter survival of patients with lowgrade diffuse gliomas logrank test P=0047 but when each histological type was analyzed separately an association was observed only for oligoastrocytoma P=005 Loss on 1p and 19q were assessed by quantitative microsatellite analysis in 67 of cases These alterations were frequent in oligodendrogliomas 1p 57 19q 69 less common in oligoastrocytomas 1p 27 19q 45 rare in fibrillary astrocytomas 1p 7 19q 7 and absent in gemistocytic astrocytomas None of these alterations were predictive of survival These results establish the frequency of key genetic alterations in lowgrade diffuse gliomas at a populationbased level Multivariate Cox’s regression analysis indicates that only age and histological type but not genetic alterations are significant predictive factors
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