Transformation of low grade glioma and correlation with outcome: An NCCTG database analysis

K. A. Jaeckle, P. A. Decker, K. V. Ballman, P. J. Flynn, C. Giannini, B. W. Scheithauer, R. B. Jenkins, J. C. Buckner

Research output: Contribution to journalReview article

52 Citations (Scopus)

Abstract

Glioblastomas (GBM) may originate de novo (primary), or following transformation from a lower grade glioma (secondary), and it has been postulated that these tumors may have different biological behaviors. We performed a correlative analysis involving 204 patients with glioma treated prospectively on NCCTG clinical trials. Central pathology review of tumor tissues taken at the time of initial diagnosis and at recurrence were performed in all patients. Tumors progressed from low (WHO grade 2) to high (grade 3-4) at recurrence in 45% low grade oligodendroglioma patients, in 70% with low grade oligoastrocytoma, and 74% with low grade astrocytoma (P = 0.031). Median overall survival (OS) from initial diagnosis varied by histology: oligodendroglioma, 8.8 years; (95% CI 5.7-10.2); oligoastrocytoma, 4.4 years (95% CI 3.5-5.6); astrocytoma grade 2 3.1 years (astrocytoma grade 2-4, 2.1 years) (95% CI 1.7-2.5, P < 0.001). Mean time to recurrence (TTR) also varied between patients with de novo GBM, those secondary GBM, and those that remained non-GBM at recurrence (1.1 ± 1.1 vs. 2.9 ± 1.8 vs. 4.0 ± 2.9 years, respectively, P < 0.001). Median OS from time of recurrence also varied between these three categories (0.7 years, 95% CI: 0.5-1.1 vs. 0.6 years, CI: 0.5-1.0 vs. 1.4 years, 95% CI: 1.1-2.0, respectively) (P < 0.001). At time of relapse, transformation to higher grade is frequent in low grade pure and mixed astrocytomas, but is observed in less than half of those with low grade oligodendroglioma. From time of recurrence, OS was not significantly different for those with primary versus secondary GBM, and it may thus be reasonable include patients with secondary GBM in clinical therapeutic trials for recurrent disease.

Original languageEnglish (US)
Pages (from-to)253-259
Number of pages7
JournalJournal of Neuro-Oncology
Volume104
Issue number1
DOIs
StatePublished - Aug 1 2011

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Glioma
Glioblastoma
Databases
Recurrence
Astrocytoma
Oligodendroglioma
Survival
Clinical Trials
Neoplasms
Histology
Pathology

All Science Journal Classification (ASJC) codes

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Jaeckle, K. A., Decker, P. A., Ballman, K. V., Flynn, P. J., Giannini, C., Scheithauer, B. W., ... Buckner, J. C. (2011). Transformation of low grade glioma and correlation with outcome: An NCCTG database analysis. Journal of Neuro-Oncology, 104(1), 253-259. https://doi.org/10.1007/s11060-010-0476-2
Jaeckle, K. A. ; Decker, P. A. ; Ballman, K. V. ; Flynn, P. J. ; Giannini, C. ; Scheithauer, B. W. ; Jenkins, R. B. ; Buckner, J. C. / Transformation of low grade glioma and correlation with outcome : An NCCTG database analysis. In: Journal of Neuro-Oncology. 2011 ; Vol. 104, No. 1. pp. 253-259.
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abstract = "Glioblastomas (GBM) may originate de novo (primary), or following transformation from a lower grade glioma (secondary), and it has been postulated that these tumors may have different biological behaviors. We performed a correlative analysis involving 204 patients with glioma treated prospectively on NCCTG clinical trials. Central pathology review of tumor tissues taken at the time of initial diagnosis and at recurrence were performed in all patients. Tumors progressed from low (WHO grade 2) to high (grade 3-4) at recurrence in 45{\%} low grade oligodendroglioma patients, in 70{\%} with low grade oligoastrocytoma, and 74{\%} with low grade astrocytoma (P = 0.031). Median overall survival (OS) from initial diagnosis varied by histology: oligodendroglioma, 8.8 years; (95{\%} CI 5.7-10.2); oligoastrocytoma, 4.4 years (95{\%} CI 3.5-5.6); astrocytoma grade 2 3.1 years (astrocytoma grade 2-4, 2.1 years) (95{\%} CI 1.7-2.5, P < 0.001). Mean time to recurrence (TTR) also varied between patients with de novo GBM, those secondary GBM, and those that remained non-GBM at recurrence (1.1 ± 1.1 vs. 2.9 ± 1.8 vs. 4.0 ± 2.9 years, respectively, P < 0.001). Median OS from time of recurrence also varied between these three categories (0.7 years, 95{\%} CI: 0.5-1.1 vs. 0.6 years, CI: 0.5-1.0 vs. 1.4 years, 95{\%} CI: 1.1-2.0, respectively) (P < 0.001). At time of relapse, transformation to higher grade is frequent in low grade pure and mixed astrocytomas, but is observed in less than half of those with low grade oligodendroglioma. From time of recurrence, OS was not significantly different for those with primary versus secondary GBM, and it may thus be reasonable include patients with secondary GBM in clinical therapeutic trials for recurrent disease.",
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Jaeckle, KA, Decker, PA, Ballman, KV, Flynn, PJ, Giannini, C, Scheithauer, BW, Jenkins, RB & Buckner, JC 2011, 'Transformation of low grade glioma and correlation with outcome: An NCCTG database analysis', Journal of Neuro-Oncology, vol. 104, no. 1, pp. 253-259. https://doi.org/10.1007/s11060-010-0476-2

Transformation of low grade glioma and correlation with outcome : An NCCTG database analysis. / Jaeckle, K. A.; Decker, P. A.; Ballman, K. V.; Flynn, P. J.; Giannini, C.; Scheithauer, B. W.; Jenkins, R. B.; Buckner, J. C.

In: Journal of Neuro-Oncology, Vol. 104, No. 1, 01.08.2011, p. 253-259.

Research output: Contribution to journalReview article

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T1 - Transformation of low grade glioma and correlation with outcome

T2 - An NCCTG database analysis

AU - Jaeckle, K. A.

AU - Decker, P. A.

AU - Ballman, K. V.

AU - Flynn, P. J.

AU - Giannini, C.

AU - Scheithauer, B. W.

AU - Jenkins, R. B.

AU - Buckner, J. C.

PY - 2011/8/1

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N2 - Glioblastomas (GBM) may originate de novo (primary), or following transformation from a lower grade glioma (secondary), and it has been postulated that these tumors may have different biological behaviors. We performed a correlative analysis involving 204 patients with glioma treated prospectively on NCCTG clinical trials. Central pathology review of tumor tissues taken at the time of initial diagnosis and at recurrence were performed in all patients. Tumors progressed from low (WHO grade 2) to high (grade 3-4) at recurrence in 45% low grade oligodendroglioma patients, in 70% with low grade oligoastrocytoma, and 74% with low grade astrocytoma (P = 0.031). Median overall survival (OS) from initial diagnosis varied by histology: oligodendroglioma, 8.8 years; (95% CI 5.7-10.2); oligoastrocytoma, 4.4 years (95% CI 3.5-5.6); astrocytoma grade 2 3.1 years (astrocytoma grade 2-4, 2.1 years) (95% CI 1.7-2.5, P < 0.001). Mean time to recurrence (TTR) also varied between patients with de novo GBM, those secondary GBM, and those that remained non-GBM at recurrence (1.1 ± 1.1 vs. 2.9 ± 1.8 vs. 4.0 ± 2.9 years, respectively, P < 0.001). Median OS from time of recurrence also varied between these three categories (0.7 years, 95% CI: 0.5-1.1 vs. 0.6 years, CI: 0.5-1.0 vs. 1.4 years, 95% CI: 1.1-2.0, respectively) (P < 0.001). At time of relapse, transformation to higher grade is frequent in low grade pure and mixed astrocytomas, but is observed in less than half of those with low grade oligodendroglioma. From time of recurrence, OS was not significantly different for those with primary versus secondary GBM, and it may thus be reasonable include patients with secondary GBM in clinical therapeutic trials for recurrent disease.

AB - Glioblastomas (GBM) may originate de novo (primary), or following transformation from a lower grade glioma (secondary), and it has been postulated that these tumors may have different biological behaviors. We performed a correlative analysis involving 204 patients with glioma treated prospectively on NCCTG clinical trials. Central pathology review of tumor tissues taken at the time of initial diagnosis and at recurrence were performed in all patients. Tumors progressed from low (WHO grade 2) to high (grade 3-4) at recurrence in 45% low grade oligodendroglioma patients, in 70% with low grade oligoastrocytoma, and 74% with low grade astrocytoma (P = 0.031). Median overall survival (OS) from initial diagnosis varied by histology: oligodendroglioma, 8.8 years; (95% CI 5.7-10.2); oligoastrocytoma, 4.4 years (95% CI 3.5-5.6); astrocytoma grade 2 3.1 years (astrocytoma grade 2-4, 2.1 years) (95% CI 1.7-2.5, P < 0.001). Mean time to recurrence (TTR) also varied between patients with de novo GBM, those secondary GBM, and those that remained non-GBM at recurrence (1.1 ± 1.1 vs. 2.9 ± 1.8 vs. 4.0 ± 2.9 years, respectively, P < 0.001). Median OS from time of recurrence also varied between these three categories (0.7 years, 95% CI: 0.5-1.1 vs. 0.6 years, CI: 0.5-1.0 vs. 1.4 years, 95% CI: 1.1-2.0, respectively) (P < 0.001). At time of relapse, transformation to higher grade is frequent in low grade pure and mixed astrocytomas, but is observed in less than half of those with low grade oligodendroglioma. From time of recurrence, OS was not significantly different for those with primary versus secondary GBM, and it may thus be reasonable include patients with secondary GBM in clinical therapeutic trials for recurrent disease.

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Jaeckle KA, Decker PA, Ballman KV, Flynn PJ, Giannini C, Scheithauer BW et al. Transformation of low grade glioma and correlation with outcome: An NCCTG database analysis. Journal of Neuro-Oncology. 2011 Aug 1;104(1):253-259. https://doi.org/10.1007/s11060-010-0476-2