Survival of Ventricular and Periventricular High-Grade Gliomas: A Surveillance, Epidemiology, and End Results Program–Based Study

Wuyang Yang, Tao Xu, Tomas Garzon-Muvdi, Changchuan Jiang, Judy Huang, Kaisorn L. Chaichana

Research output: Contribution to journalArticle

Abstract

Background: Aggressiveness of surgical resection for periventricular/ventricular high-grade gliomas (HGGs) is determined by operative risks and assumed effectiveness of radiation therapy (RT) on residual tumor. We aimed to clarify the impact of surgery and postoperative RT on patient survival in a population-based study. Methods: This population-based study used the Surveillance, Epidemiology, and End Results (SEER) database. Patients with ventricular malignant tumors were screened for HGGs. In accordance with the World Health Organization (WHO) 2016 classification, we included cases with “diffuse astrocytic and oligodendroglial tumors,” “other astrocytic tumors,” “ependymal tumors,” and “other gliomas”. Tumor grading followed definitions established by the WHO with supplementation from SEER classifications. Only grades III and IV were included. Individual factors were assessed by hazard ratio (HR) from multivariable survival analysis using accelerated failure time (AFT) regression. Results: We included 353 patients after application of inclusion and exclusion criteria. The mean patient age was 38.77 ± 24.95 years, and the cohort was 61.5% male. Overall median survival was 12 months, with notable improvement over the last 3 decades. In a multivariate AFT model, older age (per 10-year increase, HR, 1.19; P < 0.001) was the sole nontreatment variable found to predict survival, whereas postoperative RT had a significant survival benefit (HR, 0.50; P < 0.001). No tumor characteristic (e.g., size, extent of invasion) predicted prognosis. Interestingly, neither partial resection nor TR/GTR was associated with improved outcome. Conclusions: The prognosis of ventricular HGGs is poor, with worse prognosis in older patients. We found no evidence to support aggressive surgical resection. Postoperative chemoradiation should be administered; however, the benefit of modification of the protocol for chemoradiation specifically for ventricular HGGs remains unknown and warrants further investigation.

Original languageEnglish (US)
Pages (from-to)e323-e334
JournalWorld Neurosurgery
Volume111
DOIs
StatePublished - Mar 1 2018

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Glioma
Epidemiology
Survival
Radiotherapy
Neoplasms
Neoplasm Grading
Residual Neoplasm
Survival Analysis
Population
Databases

Keywords

  • Glioblastoma
  • Glioma
  • High-grade
  • Periventricular
  • Ventricle

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Survival of Ventricular and Periventricular High-Grade Gliomas : A Surveillance, Epidemiology, and End Results Program–Based Study. / Yang, Wuyang; Xu, Tao; Garzon-Muvdi, Tomas; Jiang, Changchuan; Huang, Judy; Chaichana, Kaisorn L.

In: World Neurosurgery, Vol. 111, 01.03.2018, p. e323-e334.

Research output: Contribution to journalArticle

Yang, Wuyang ; Xu, Tao ; Garzon-Muvdi, Tomas ; Jiang, Changchuan ; Huang, Judy ; Chaichana, Kaisorn L. / Survival of Ventricular and Periventricular High-Grade Gliomas : A Surveillance, Epidemiology, and End Results Program–Based Study. In: World Neurosurgery. 2018 ; Vol. 111. pp. e323-e334.
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abstract = "Background: Aggressiveness of surgical resection for periventricular/ventricular high-grade gliomas (HGGs) is determined by operative risks and assumed effectiveness of radiation therapy (RT) on residual tumor. We aimed to clarify the impact of surgery and postoperative RT on patient survival in a population-based study. Methods: This population-based study used the Surveillance, Epidemiology, and End Results (SEER) database. Patients with ventricular malignant tumors were screened for HGGs. In accordance with the World Health Organization (WHO) 2016 classification, we included cases with “diffuse astrocytic and oligodendroglial tumors,” “other astrocytic tumors,” “ependymal tumors,” and “other gliomas”. Tumor grading followed definitions established by the WHO with supplementation from SEER classifications. Only grades III and IV were included. Individual factors were assessed by hazard ratio (HR) from multivariable survival analysis using accelerated failure time (AFT) regression. Results: We included 353 patients after application of inclusion and exclusion criteria. The mean patient age was 38.77 ± 24.95 years, and the cohort was 61.5{\%} male. Overall median survival was 12 months, with notable improvement over the last 3 decades. In a multivariate AFT model, older age (per 10-year increase, HR, 1.19; P < 0.001) was the sole nontreatment variable found to predict survival, whereas postoperative RT had a significant survival benefit (HR, 0.50; P < 0.001). No tumor characteristic (e.g., size, extent of invasion) predicted prognosis. Interestingly, neither partial resection nor TR/GTR was associated with improved outcome. Conclusions: The prognosis of ventricular HGGs is poor, with worse prognosis in older patients. We found no evidence to support aggressive surgical resection. Postoperative chemoradiation should be administered; however, the benefit of modification of the protocol for chemoradiation specifically for ventricular HGGs remains unknown and warrants further investigation.",
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T1 - Survival of Ventricular and Periventricular High-Grade Gliomas

T2 - A Surveillance, Epidemiology, and End Results Program–Based Study

AU - Yang, Wuyang

AU - Xu, Tao

AU - Garzon-Muvdi, Tomas

AU - Jiang, Changchuan

AU - Huang, Judy

AU - Chaichana, Kaisorn L.

PY - 2018/3/1

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AB - Background: Aggressiveness of surgical resection for periventricular/ventricular high-grade gliomas (HGGs) is determined by operative risks and assumed effectiveness of radiation therapy (RT) on residual tumor. We aimed to clarify the impact of surgery and postoperative RT on patient survival in a population-based study. Methods: This population-based study used the Surveillance, Epidemiology, and End Results (SEER) database. Patients with ventricular malignant tumors were screened for HGGs. In accordance with the World Health Organization (WHO) 2016 classification, we included cases with “diffuse astrocytic and oligodendroglial tumors,” “other astrocytic tumors,” “ependymal tumors,” and “other gliomas”. Tumor grading followed definitions established by the WHO with supplementation from SEER classifications. Only grades III and IV were included. Individual factors were assessed by hazard ratio (HR) from multivariable survival analysis using accelerated failure time (AFT) regression. Results: We included 353 patients after application of inclusion and exclusion criteria. The mean patient age was 38.77 ± 24.95 years, and the cohort was 61.5% male. Overall median survival was 12 months, with notable improvement over the last 3 decades. In a multivariate AFT model, older age (per 10-year increase, HR, 1.19; P < 0.001) was the sole nontreatment variable found to predict survival, whereas postoperative RT had a significant survival benefit (HR, 0.50; P < 0.001). No tumor characteristic (e.g., size, extent of invasion) predicted prognosis. Interestingly, neither partial resection nor TR/GTR was associated with improved outcome. Conclusions: The prognosis of ventricular HGGs is poor, with worse prognosis in older patients. We found no evidence to support aggressive surgical resection. Postoperative chemoradiation should be administered; however, the benefit of modification of the protocol for chemoradiation specifically for ventricular HGGs remains unknown and warrants further investigation.

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KW - Periventricular

KW - Ventricle

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