title: Clinicopathologic study of forty-four histologically pure supratentorial oligodendrogliomas.
abstract: Few studies in recent years have specifically focused on pure oligodendroglial neoplasms. We retrospectively reviewed the clinicopathologic features of 44 patients with supratentorial oligodendroglioma diagnosed over a 19-year period (1974 to 1993). The study group consisted of 44 patients (age range, 8 to 69 years; median, 42 years), including 31 males. Thirty-one initially resected tumors (70%) were low grade and 13 (30%) were high grade (anaplastic). Using the St Anne-Mayo criteria for astrocytic tumors, 19 tumors (43%) were grade 2, 17 (39%) were grade 3, and 8 were (18%) grade 4. Histologic features of the tumors at initial resection included prominent nucleoli (N = 18, 41%), vascular proliferation (N = 9, 20%), necrosis (N = 6, 14%), and microcystic degeneration (N = 23, 52%). Nuclear atypia was graded as mild in 22 tumors (50%), moderate in 18 (41%), and marked in four (9%). The highest mitosis counts ranged from 0 to 10 mitotic figures (MF)/10 high-power fields (HPF) (mean, 2.4). Twelve patients (27%) had four or more MF/10 HPF. Initial surgery included gross total resection in 10 patients, subtotal resection in 16 patients, and biopsy in 14 patients. Thirty-one patients received adjuvant radiotherapy and 15 received chemotherapy. MIB-1 labeling indices ranged from 0 to 42.3 (median, 1.2 [low grade tumor median, 0.5; anaplastic tumor median, 6.2]). p53 immunostaining was observed in 18 of 43 stained tumors (41%). Overall, 5- and 10-year survival rates were 71% and 63%, respectively. The entire group had a median follow-up of 5.2 years. Age greater than 45 years (P = .02), mitosis counts of > or =4 MF/10 HPF (P = .0004), and MIB-1 labeling indices <2 (P = .03) were independent predictors of survival (Kaplan-Meier analysis). MIB-1 labeling indices <2 (P = .0009) was an independent predictor of disease-free survival. Low cell density (P = .04) and low histologic grade (P = .03) show trends with regard to being associated with longer survival. In conclusion, older patients (>45 years) or patients with tumors with an increased rate of cell proliferation generally have a worse prognosis. Although tumors of high histologic grade generally have a worse survival, the correlation was not statistically significant.
authors.affiliation: Department of Anatomic Pathology, The Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Prayson
authors.forename: D S
authors.initials: DS
authors.lastname: Mohan
authors.forename: P
authors.initials: P
authors.lastname: Song
authors.forename: J H
authors.initials: JH
authors.lastname: Suh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor / Q000378:metabolism; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009687:Nuclear Proteins / Q000276:immunology / Q000378:metabolism; D009837:Oligodendroglioma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000276:immunology / Q000378:metabolism
chemical_list: D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D009687:Nuclear Proteins; D016159:Tumor Suppressor Protein p53