Recursive partitioning analysis of prognostic factors in WHO grade III glioma patients treated with radiotherapy or radiotherapy plus chemotherapy.
BACKGROUND
We evaluated the hierarchical risk groups for the estimated survival of WHO grade III glioma patients using recursive partitioning analysis (RPA). To our knowledge, this is the first study to address the results of RPA specifically for WHO grade III gliomas.


METHODS
A total of 133 patients with anaplastic astrocytoma (AA, n = 56), anaplastic oligodendroglioma (AO, n = 67), or anaplastic oligoastrocytoma (AOA, n = 10) were included in the study. These patients were treated with either radiotherapy alone or radiotherapy followed by PCV chemotherapy after surgery. Five prognostic factors, including histological subsets, age, performance status, extent of resection, and treatment modality were incorporated into the RPA. The final nodes of RPA were grouped according to their survival times, and the Kaplan-Meier graphs are presented as the final set of prognostic groups.


RESULTS
Four risk groups were defined based on the clinical prognostic factors excluding age, and split variables were all incorporated into the RPA. Survival analysis showed significant differences in mean survival between the different groups: 163.4 months (95% CI: 144.9-182.0), 109.5 months (86.7-132.4), 66.6 months (50.8-82.4), and 27.7 months (16.3-39.0), respectively, from the lowest to the highest risk group (p = 0.00).


CONCLUSIONS
The present study shows that RPA grouping with clinical prognostic factors can successfully predict the survival of patients with WHO grade III glioma.
Park
Chul-Kee
CK
Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University, Seoul 110-744, Korea. nsckpark@paran.com
Lee
Se-Hoon
SH
Han
Jung Ho
JH
Kim
Chae-Yong
CY
Kim
Dong-Wan
DW
Paek
Sun Ha
SH
Kim
Dong Gyu
DG
Heo
Dae Seog
DS
Kim
Il Han
IH
Jung
Hee-Won
HW
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002945:Cisplatin / Q000627:therapeutic use; D002965:Classification / Q000379:methods*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D005910:Glioma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D014751:Vindesine / Q000627:therapeutic use; D014944:World Health Organization
D003520:Cyclophosphamide; D002945:Cisplatin; D014751:Vindesine