title: Importance of baseline mini-mental state examination as a prognostic factor for patients with low-grade glioma.
abstract: OBJECTIVE
  The outcome and cognitive performance data collected in a prospective, intergroup clinical trial were analyzed to assess the prognostic importance of the baseline (before radiotherapy) Mini-Mental State Examination (MMSE) score in patients with low-grade glioma.
  
  
  METHODS
  The patients studied were 203 adults with a supratentorial low-grade glioma randomly assigned to low-dose (50.4 Gy in 28 fractions) or high-dose (64.8 Gy in 36 fractions) localized radiotherapy. Folstein MMSE scores and neurologic function scores at baseline in combination with multiple other baseline variables were analyzed. The median follow-up was 7.4 years for the 101 patients still alive.
  
  
  RESULTS
  Patients (n = 36) with an abnormal baseline MMSE score (< or =26) had a worse 5-year progression-free survival rate (27% vs. 60%; p <0.001) and overall survival rate (31% vs. 76%; p <0.001) compared with those with a normal score. On multivariate analysis, the baseline MMSE score was a statistically significant predictor of survival. Other factors associated with overall survival were age, tumor size, and tumor histologic type.
  
  
  CONCLUSIONS
  The presence of an abnormal baseline MMSE score was a strong predictor of poorer progression-free and overall survival for patients with a low-grade glioma. The baseline MMSE should be considered in future prognostic scoring systems.
authors.affiliation: Division of Radiation Ocology, Mayo Clinic, Rochester, MN 55905, USA. brown.paul@mayo.edu
authors.forename: Paul D
authors.initials: PD
authors.lastname: Brown
authors.forename: Jan C
authors.initials: JC
authors.lastname: Buckner
authors.forename: Judith R
authors.initials: JR
authors.lastname: O'Fallon
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Iturria
authors.forename: Brian P
authors.initials: BP
authors.lastname: O'Neill
authors.forename: Cerise A
authors.initials: CA
authors.lastname: Brown
authors.forename: Bernd W
authors.initials: BW
authors.lastname: Scheithauer
authors.forename: Robert P
authors.initials: RP
authors.lastname: Dinapoli
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arusell
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Curran
authors.forename: Ross
authors.initials: R
authors.lastname: Abrams
authors.forename: Edward G
authors.initials: EG
authors.lastname: Shaw
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003071:Cognition; D018450:Disease Progression; D005260:Female; D005910:Glioma / Q000401:mortality / Q000523:psychology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D015173:Supratentorial Neoplasms / Q000401:mortality / Q000523:psychology* / Q000532:radiotherapy; D016019:Survival Analysis