The Outcome of Anaplastic Glioma Treated at a Tertiary Cancer Care Institute in South Asia

Abstract

Objective: Anaplastic glioma is a highly aggressive brain tumor that often occurs in young adults. There is a lack of data from India on anaplastic gliomas. This study aims to evaluate the prognostic factors of anaplastic glioma and correlate them with the outcome. Materials and Methods: This is a retrospective observational study of 57 patients with anaplastic glioma treated from 1996 to 2015 in a cancer institute in Chennai. We captured data from the cancer institute’s hospital-based electronic health record tumor registry and correlated factors including age, sex, histology, site of disease, type of surgery, adjuvant treatment, and radiation treatment technique with outcome. For the calculation of progression-free survival (PFS) and Overall Survival (OS), we used Statistical Package for Social Science (SPSS) software. Result: This analysis included fifty-seven patients, with a median follow-up of 34 months. The median progression-free survival (PFS) and overall survival (OS) were 28 and 41 months, respectively. On univariate analysis, factors associated with improved survival include Anaplastic Oligodendroglioma histology (HR-0.43, CI-0.22-0.80, P=0.006), Frontal lobe location (HR-1.96, CI-1.07-3.58, P=0.025) Gross total resection (HR-1.94, CI-1.03-3.64, P=0.034), and addition of Temozolamide (HR-2.09, CI-1.14-3.84, P=0.014). On multivariate analysis Anaplastic Oligodendroglioma histology, (HR-0.49,CI-0.25-0.95,P=0.037), Frontal lobe (HR-2.14,CI-1.12-4.07,P=0.021), Gross total resection (HR-2.89,CI-1.47-5.69,P=0.002) and addition of Temozolamide (HR-2.02,CI-1.07-3.81,P=0.029) remained significant factors for improved OS. Conclusion: Among the various clinical and treatment-related prognostic factors, our study revealed that anaplastic oligodendroglioma histology, frontal lobe location, gross total resection, and addition of temozolomide chemotherapy to radiation showed improved outcomes.