title: Free survival time of recurrence and malignant transformation and associated factors in patients with supratentorial low-grade gliomas.
abstract: OBJECTIVE
  To determine the recurrence and malignancy free survival time and associated factors with recurrence and malignant transformation of patients with low-grade gliomas after primary surgical resection.
  
  
  METHODS
  The present study was retrospective. Patients who underwent surgery and were diagnosed with low-grade gliomas between January 2000 and October 2009 were recruited. Time to recurrence and malignant transformation were analyzed using Kaplan-Meier method and multivariate Cox proportional hazard regression models.
  
  
  RESULTS
  Seventy-seven patients underwent surgery for low-grade glioma. The pathological reports were diffuse astrocytoma in 55 patients (71%), oligodendroglioma in 19 patients (25%), and oligoastrocytoma in three patients (40%). The types of tumor resection were biopsy in 39 patients (50%), subtotal resection 34 patients (44%), and total resection in four patients (5%). The overall mean time to follow-up was 40 months, the median recurrence and malignant transformation times were 14 and 24 months. The 5-year recurrence-free and malignant-free survival rate was 50% and 68%. Factors associated with tumor recurrence were age, sex, presenting symptoms, preoperative Karnofsky performance status (KPS) score, tumor volume, and contrast enhancement. None of these factors showed statistically significant association with malignant transformation.
  
  
  CONCLUSIONS
  One fourth of the patients had tumor recurrence and malignant transformation in a short period of time. Delayed recurrence and malignant transformation after primary resection are associated with several factors. The type of surgery especially total-subtotal resection might favor prognosis.
authors: Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. it_swu039@hotmail.com
authors: Ittichai
authors: I
authors: Sakarunchai
authors: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors: Rassamee
authors: R
authors: Sangthong
authors: Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors: Nakornchai
authors: N
authors: Phuenpathom
authors: Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors: Monlika
authors: M
authors: Phukaoloun
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic; D003287:Contrast Media; D005260:Female; D005910:Glioma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D003287:Contrast Media