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Neuro Oncol. 2017 May 1;19(5):678-688. doi: 10.1093/neuonc/now186.

Natural course and prognosis of anaplastic gangliogliomas: a multicenter retrospective study of 43 cases from the French Brain Tumor Database.

Author information

1
CHRU de Tours, Service de Neurochirurgie, Tours, France.
2
Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France.
3
Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France.
4
French Brain Tumor DataBase, ICM, Montpellier, France.
5
Department of Neuropathology and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France.
6
Department of Neurosurgery, Hôpital La Pitié Salpétrière, APHP, Paris, France.
7
Plateforme CIRE, UMR-PRC, 37380 Nouzilly, Centre INRA Val de Loire, France.
8
Université François-Rabelais de Tours, Tours, France.
9
Inserm, CIC 1415, CHRU de Tours, Tours, France.
10
Service de Neurochirurgie, CHU Jean-Minjoz, 3 boulevard Alexander-Fleming, Besançon cedex, France.
11
Department of Neurosurgery, Hôpital Pasteur, University Hospital Center, 06000, Nice, France.
12
Department of Pathology, Hôpital François Mitterand, CHU de Dijon, 14 rue Paul Gaffarel, 21000 Dijon, France.
13
Service d'Anatomie et Cytologie Patholgique, CHRU de Tours, Tours, France.
14
Department of Neurosurgery and Neurotraumatology, Nantes University Hospital, Nantes, France.
15
Department of Neurosurgery, CHU de la Cavale Blanche, Brest, France.
16
Department of Neurosurgery, Cèdres Hospital, Toulouse, France.
17
Laboratoire Universitaire d'Anatomie Patholgique, Neuropathologie humaine et expérimentale, CHU Rangueil, Toulouse, France.
18
Department of Neurosurgery, University Hospital of Caen, Caen, France.
19
Service de Neurochirurgie, Hôpital François Mitterand, CHU de Dijon, 14 rue Paul Gaffarel, 21000 Dijon, France.
20
Department of Pathology, CHU Nancy and INSERM U954, Faculty of Medicine, Université de Lorraine, France.
21
Department of Pathology, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
22
Department of Neurosurgery, Neurological Hospital, Lyon, France.
23
Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
24
Service de Neuroradiologie, CHRU de Tours, Tours, France.
25
Department of Neurosurgery, University Hospital Pontchaillou, 2, Rue Henri Le Guilloux, 35000, Rennes, France.
26
Service de neurochirurgie A, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
27
Université de Bordeaux - Service de Neurochirurgie B, hôpital Pellegrin Tripode, Bordeaux, France.
28
Department of Neurosurgery, Fondation Ophtalmologique Rothschild, Paris, France.
29
Service de neurochirurgie, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA, Toulouse, France.
30
Department of Neurosurgery, Lariboisière Hospital, 75010 Paris, France.
31
Département de neurochirurgie, CHU d'Angers, 4, rue Larrey, 49940 Angers cedex 9, France.
32
Département de neurochirurgie, Aix-Marseille université, CHU Timone, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
33
Department of Pathology, CHU de Poitiers, Hôpital la Milétrie, Poitiers, France.
34
Department of Neurosurgery, Orléans Hospital, France.
35
Service de Neurochirurgie, Hôpital Nord, APHM, University Hospital of Marseille Aix-Marseille Univ, Marseille, France.
36
Département de Pathologie Cellulaire et Tissulaire, Centre Hospitalo-universitaire d'Angers, 4 rue Larrey, Angers Cedex, France.
37
CHU Toulouse, Hôpital de Rangueil, Service d'Anatomie et Cytologie Pathologique, Toulouse, France.
38
Bordeaux Institute of Neuroscience, CNRS UMR 5227, F-33076, Bordeaux, France.
39
Department of Neurosurgery, Strasbourg-Colmar Hospital, France.
40
Department of Neurosurgery, Imaging Laboratory, University Hospital Poitiers, 2 Rue de La Miletrie, Poitiers Cedex, France.
41
Paris Descartes University, Sorbonne Paris Cité, Paris, France.
42
Department of Neurosurgery, Sainte-Anne Hospital, Paris, France.
43
Department of Neuropathology, Sainte-Anne Hospital, Paris, France.
44
CHU Timone, Marseille, France.

Abstract

Background:

Anaplastic gangliogliomas (GGGs) are rare tumors whose natural history is poorly documented. We aimed to define their clinical and imaging features and to identify prognostic factors.

Methods:

Consecutive cases of anaplastic GGGs in adults prospectively entered into the French Brain Tumor Database between March 2004 and April 2014 were screened. After diagnosis was confirmed by pathological review, clinical, imaging, therapeutic, and outcome data were collected retrospectively.

Results:

Forty-three patients with anaplastic GGG (median age, 49.4 y) from 18 centers were included. Presenting symptoms were neurological deficit (37.2%), epileptic seizure (37.2%), or increased intracranial pressure (25.6%). Typical imaging findings were unifocal location (94.7%), contrast enhancement (88.1%), central necrosis (43.2%), and mass effect (47.6%). Therapeutic strategy included surgical resection (95.3%), adjuvant radiochemotherapy (48.8%), or radiotherapy alone (27.9%). Median progression-free survival (PFS) and overall survival (OS) were 8.0 and 24.7 months, respectively. Three- and 5-year tumor recurrence rates were 69% and 100%, respectively. The 5-year survival rate was 24.9%. Considering unadjusted significant prognostic factors, tumor midline crossing and frontal location were associated with shorter OS. Temporal and parietal locations were associated with longer and shorter PFS, respectively. None of these factors remained statistically significant in multivariate analysis.

Conclusions:

We report a large series providing clinical, imaging, therapeutic, and prognostic features of adult patients treated for an intracerebral anaplastic GGG. Our results show that pathological diagnosis is difficult, that survivals are only slightly better than for glioblastomas, and that complete surgical resection followed with adjuvant chemoradiotherapy offers longer survival.

KEYWORDS:

anaplastic ganglioglioma; cerebral malignancy; prognosis; surgery

PMID:
28453747
PMCID:
PMC5464461
DOI:
10.1093/neuonc/now186
[Indexed for MEDLINE]
Free PMC Article

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