title: New clinical, pathological and molecular prognostic models and calculators in patients with locally diagnosed anaplastic oligodendroglioma or oligoastrocytoma. A prognostic factor analysis of European Organisation for Research and Treatment of Cancer Brain Tumour Group Study 26951.
abstract: BACKGROUND
  The prognosis of patients with anaplastic oligodendrogliomas (AOD) and oligoastrocytomas (AOA) is variable. Biomarkers might be helpful to identify more homogeneous disease subtypes and improve therapeutic index. The aim of this study is to develop new clinical, pathological and molecular prognostic models for locally diagnosed anaplastic gliomas with oligodendroglial features (AOD or AOA).
  
  
  METHODS
  Data from 368 patients with AOD or AOA recruited in The European Organisation for Research and Treatment of Cancer (EORTC) trial 26951 on adjuvant PCV (Procarbazine, CCNU, Vincristine) chemotherapy in anaplastic oligodendroglial tumours were used to develop multifactor models to predict progression free survival (PFS) and overall survival (OS). Different models were compared by their percentage of explained variation (PEV). Prognostic calculators were derived from these new models.
  
  
  RESULTS
  Treatment (for PFS only), younger age, confirmed absence of residual tumour on imaging, frontal location, good World Health Organisation (WHO) performance status, absence of endothelial abnormalities and/or necrosis, 1p/19q codeletion and Isocitrate dehydrogenase 1 (IDH1) mutation were independent factors that predicted better PFS and OS.
  
  
  CONCLUSIONS
  We identified important prognostic factors for AOD and AOA and showed that molecular markers added a major contribution to clinical and pathological factors in explaining PFS and OS. With a positive predictive value of 92% for PFS and 94% for OS, our models allow physicians to precisely identify high risk patients and aid in making therapeutic decisions.
authors.affiliation: EORTC Headquarters, Brussels, Belgium. Electronic address: thierry.gorlia@eortc.be.
authors.forename: Thierry
authors.initials: T
authors.lastname: Gorlia
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Delattre
authors.forename: Alba A
authors.initials: AA
authors.lastname: Brandes
authors.forename: Johan M
authors.initials: JM
authors.lastname: Kros
authors.forename: Martin J B
authors.initials: MJ
authors.lastname: Taphoorn
authors.forename: Mathilde C M
authors.initials: MC
authors.lastname: Kouwenhoven
authors.forename: H J J A
authors.initials: HJ
authors.lastname: Bernsen
authors.forename: Marc
authors.initials: M
authors.lastname: Frénay
authors.forename: Cees C
authors.initials: CC
authors.lastname: Tijssen
authors.forename: Denis
authors.initials: D
authors.lastname: Lacombe
authors.forename: Martin J
authors.initials: MJ
authors.lastname: van den Bent
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001254:Astrocytoma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D014408:Biomarkers, Tumor / Q000235:genetics; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant; D003661:Decision Support Techniques; D018572:Disease-Free Survival; D005060:Europe; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009837:Oligodendroglioma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D018579:Patient Selection; D011344:Procarbazine / Q000008:administration & dosage; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine
keywords: Cox models; Oligoastrocytomas; Oligodendrogliomas; Prognostic factors