Importance of baseline mini-mental state examination as a prognostic factor for patients with low-grade glioma.
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.
Brown
Paul D
PD
Division of Radiation Ocology, Mayo Clinic, Rochester, MN 55905, USA. brown.paul@mayo.edu
Buckner
Jan C
JC
O'Fallon
Judith R
JR
Iturria
Nancy L
NL
O'Neill
Brian P
BP
Brown
Cerise A
CA
Scheithauer
Bernd W
BW
Dinapoli
Robert P
RP
Arusell
Robert M
RM
Curran
Walter J
WJ
Abrams
Ross
R
Shaw
Edward G
EG
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