Predicting factors of tumor progression in adult patients with low-grade glioma within five years after surgery

Xuezheng Li; Ruimin Li; Hongbo Ren; He Liu; Hongfeng Liu

doi:10.21037/tcr-21-589

Predicting factors of tumor progression in adult patients with low-grade glioma within five years after surgery

Transl Cancer Res. 2021 Apr;10(4):1907-1915. doi: 10.21037/tcr-21-589.

Authors

Xuezheng Li¹, Ruimin Li¹, Hongbo Ren², He Liu³, Hongfeng Liu⁴

Affiliations

¹ Department of Clinical Examination, Handan Central Hospital of Hebei Province, Handan, China.
² Department of Neurosurgery, Handan Central Hospital of Hebei Province, Handan, China.
³ Shenzhen Mindray Bio-Medical Electronic Co., Ltd, Shenzhen, China.
⁴ Department of Hematology, Handan Central Hospital of Hebei Province, Handan, China.

Abstract

Background: Glioma is the most common primary intracranial tumor with the worst prognosis whose 5-year mortality rate is second only to pancreatic cancer and lung cancer among systemic tumors. WHO divides gliomas into grades I to IV, with grades I and II as low grades. Low-grade gliomas tend to occur in people between the ages of 30 and 40, who usually have the characteristics of well-differentiated, slow growth, and low invasiveness. Timely diagnosis and surgery are the main treatment strategies for low-grade gliomas. The current ideal treatment represents the MST reaching average seven years. However, many patients relapse with adverse outcomes. It's important to identify high-risk patients by predicting factors in adult patients with low-grade glioma.

Methods: A total of 287 patients who were treated in our hospital from February 2011 to May 2015 were included in the final analysis according to the inclusion and exclusion criteria. The patients were divided into progression-free groups and progression groups according to the results of 5-year follow-up after surgery by information like patients' baseline data, surgical data, postoperative follow-up data. The ROC was used to analyze the greatest quantitative treatment boundary value and distinguish high and low risk. Kaplan-Meier survival curve was used to analyze risk factors' predictive value for patients' postoperative results.

Results: The results of 5-year follow-up showed 122 cases (42.5%) had no progression (progression-free group), 165 cases (57.5%) had progression (progression group). Univariate and multivariate analysis showed that age older than 50 (OR =1.42, P=0.013), partial resection of tumor (OR =1.86, P=0.027), tumor diameter larger than 5 cm (OR =1.85, P=0.022) and long-term statins treatment before surgery (OR =0.36, P=0.036) were closely associated with tumor progression. The Kaplan-Meier survival curve showed patients aged older than 50, partial resection of the tumor, a tumor diameter larger than 5 cm whose results were poor, while long-term statins treatment before surgery had a better prognosis within the 5-year follow-up.

Conclusions: Patients aged older than 50, partial resection of the tumor, tumor diameter larger than 5 cm and long-term statins treatment before surgery were closely related to the prognosis after surgery.

Keywords: Glioma; prognosis; risk factors; statins.