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Oligoastrocytomas: a clinicopathological study of 52 cases

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Abstract

Oligoastrocytomas form a poorly defined subgroup of glialtumors, and few clinical series have been reported.We performed a retrospective study to elucidate thehistopathological features of these tumors and to relatethe clinical signs and symptoms and proliferative potentialto survival. Oligoastrocytomas were defined as glial tumorswith at least 10% neoplastic astrocytes and 10%neoplastic oligodendrocytes; tumors were graded with the St.Anne-Mayo criteria for astrocytomas and oligodendrogliomas. Proliferative potentialwas estimated with antibodies against proliferating cell nuclearantigen (PCNA). Median survival of 52 patients (medianage, 42 years) was 75 weeks (range 2–703weeks). Actuarial 1-, 2-, 3-, and 5-year survivalrates were 67%, 43%, 40%, and 29%, respectively.For 15 patients with grade 3 and 33with grade 4 lesions (St. Anne-Mayo astrocytoma classification),median survival was 217 and 55 weeks, respectively.For 19 patients with grade 2 and 33with grade 3 lesions (St. Anne-Mayo oligodendroglioma classification),median survival was 305 and 55 weeks, respectively.Interobserver agreement between three experienced neuropathologists on identificationof astrocytes, oligodendrocytes, and unclassifiable cells was low,indicating considerable subjectivity in the histopathological diagnosis. MedianPCNA labeling indices correlated with tumor grade, butindividual values varied so widely within grades thatthey had no predictive value for survival. Ina multivariate analysis, symptoms of increased intracranial pressureand microvascular proliferation were independently associated with poorprognosis. The biological behavior of subgroups appeared tobe distinctly less aggressive than that of ‘pure’astrocytomas of similar grade. Better histopathological definition ofoligoastrocytomas and improved assessment of percentages of constituentcell types may allow more accurate prognosis.

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References

  1. Cooper ERA: The relation of oligocytes and astrocytes in cerebral tumours. J Pathol Bacterol 41: 259–266, 1935

    Google Scholar 

  2. Willis RA: Pathology of Tumours. Butterworth & Co., London 1948, pp 802–823

    Google Scholar 

  3. Rubinstein LJ: Tumors of the central nervous system. Atlas of Tumor Pathology, Fascicle 6, Armed Forces Institute of Pathology, Washington DC, 1972

    Google Scholar 

  4. Zulch KJ: Histological Typing of Tumours of the Central Nervous System (International Histological Classification of Tumours, No. 21). World Health Organization, Geneva, 1979

    Google Scholar 

  5. Zulch KJ, Wechsler W: Pathology and classification of gliomas. Prog Neurol Surg 2: 1–84, 1968

    Google Scholar 

  6. Kleihues P, Burger PC, Scheithauer BW: Histological Typing of Tumours of the Central Nervous System, 2nd edition. World Health Organization, Geneva: Springer-Verlag, Berlin, Heidelberg, New York 11–30, 1993

    Google Scholar 

  7. Bullard DE, Rawlings CE III, Philips B, Cox EB, Schold SC, Burger P: Oligodendroglioma. An analysis of the value of radiation therapy. Cancer 60: 2179–2188, 1987

    Google Scholar 

  8. Glass J, Hochberg FH, Gruber ML, Louis DN, Smith D, Rattner B: The treatment of oligodendrogliomas and mixed oligodendroglioma-astrocytomas with PCV-chemotherapy. J Neurosurg 76: 741–745, 1992

    Google Scholar 

  9. Kyritsis AP, Yung WKA, Bruner J, Gleason MJ, Levin VA: The treatment of anaplastic oligodendrogliomas and mixed gliomas. Neurosurgery 32: 365–371, 1993

    Google Scholar 

  10. Mørk SJ, Halvorsen TB, Lindegaard K-F, Eide GE: Oligodendroglioma. Histologic evaluation and prognosis. J Neuropathol Exp Neurol 45: 65–78, 1986

    Google Scholar 

  11. Mørk SJ, Lindegaard K-F, Halvorsen TB, Lehmann EH, Solgaard T, Hatlevoll R: Oligodendroglioma: incidence and biological behavior in a defined population. J Neurosurg 63: 881–889, 1985

    Google Scholar 

  12. Smith MT, Ludwig CL, Godfrey AD, Armbrustmacher VW: Grading of oligodendrogliomas. Cancer 52: 2107–2114, 1983

    Google Scholar 

  13. Wallner KE, Gonzales M, Sheline GE: Treatment of oligodendrogliomas with or without postoperative irradiation. J Neurosurg 68: 684–688, 1988

    Google Scholar 

  14. Winger MJ, Macdonald DR, Cairncross JG: Supratentorial anaplastic gliomas in adults. The prognostic importance of extent of resection and prior low-grade glioma. J Neurosurg 71: 487–493, 1989

    Google Scholar 

  15. Hart MN, Petito CK, Earle KM: Mixed gliomas. Cancer 33: 134–140, 1974

    Google Scholar 

  16. Shaw EG, Scheithauer BW, O'Fallon JR, Davis DH: Mixed oligo-astrocytomas: a survival and prognostic factor analysis. Neurosurgery 34: 577–582, 1994

    Google Scholar 

  17. Jaskolsky D, Zawirski M, Papierz W, Kotwica Z: Mixed gliomas. Their clinical course and results of surgery. Zentralbl Neurochir 48: 120–223, 1987

    Google Scholar 

  18. Wacker MR, Hoshino T, Ahn DK, Davis RL, Prados MD: The prognostic implications of histologic classification and bromodeoxyuridine labeling index of mixed gliomas. J Neuro-Oncol 19: 13–22, 1994

    Google Scholar 

  19. Karamitopoulou E, Perentes E, Melachrinou M, Maraziotis Th: Proliferating cell nuclear antigen immunoreactivity in human central nervous system neoplasms. Acta Neuropathol 85: 316–322, 1993

    Google Scholar 

  20. Louis DN, Edgerton S, Thor AD, Hedley-Whyte ET: Proliferating cell nuclear antigen and Ki-67 immunohistochemistry in brain tumors: a comparative study. Acta Neuropathol 81: 675–679, 1991

    Google Scholar 

  21. Daumas-Duport C, Scheithauer B, O'Fallon J, Kelly P: Grading of astrocytomas. Cancer 62: 2152–2165, 1988

    Google Scholar 

  22. Daumas-Duport C: Histological grading of gliomas. Curr Opinion Neurol Neurosurg 5: 924–931, 1992

    Google Scholar 

  23. Shi S-R, Key ME, Kalra KL: Antigen retrieval in formalin-fixed, paraffin-embedded tissues: an enhancement method for immunohistochemical staining based on microwave oven heating of tissue sections. J Histochem Cytochem 741–748, 1991

  24. Kaplan EL, Meier P: Non-parametric estimation from incomplete observations. J Am Stat Assoc 53: 457–481, 1958

    Google Scholar 

  25. Cox DR: Regression models and life tables. J R Stat Soc [B] 34: 187–202, 1972

    Google Scholar 

  26. EGRET Statistical Package. Statistics and Epidemiology Research Corporation, Seattle, 1990

    Google Scholar 

  27. Lee ET, Desu MM: A computer program for comparing K samples with right censored data. Comput Programs Biomed 2: 315–321, 1972

    Google Scholar 

  28. Cohen J: A coefficient of agreement for nominal scales. Educ Psychol Measurem 20: 37–46, 1960

    Google Scholar 

  29. Burger PC, Rawlings CE, Cox EB, Mc Lendon RE, Schold SC, Bullard DE: Clinicopathologic correlations in the oligodendroglioma. Cancer 59: 1345–1352, 1987

    Google Scholar 

  30. Alvord EC Jr: Is necrosis helpful in the grading of gliomas? Editorial opinion. J Neuropathol Exp Neurol 51: 127–132, 1992

    Google Scholar 

  31. Mahaley MS Jr, Mettlin C, Natarajan N, Laws ER, Peace BB: National survey of patterns of care for brain tumor patients. J Neurosurg 71: 826–836, 1989

    Google Scholar 

  32. Shaw EG, Daumas-Duport C, Scheithauer BW, Gilbertson DT, O'Fallon JR, Earle JD: Radiation therapy in the management of low-grade supratentorial astrocytomas. J Neurosurg 70: 853–861, 1989

    Google Scholar 

  33. Laws ER Jr, Taylor WF, Clifton MB, Okazaki H: Neurosurgical management of low-grade astrocytoma of the cerebral hemispheres. J Neurosurg 61: 665–678, 1984

    Google Scholar 

  34. Shaw EG, Scheithauer BW, O'Fallon J, Tazelaar HD, Davis DH: Oligodendrogliomas: The Mayo Clinic experience. J Neurosurg 76: 428–434, 1992

    Google Scholar 

  35. Wilkinson IMS, Anderson JR, Holmes AE: Oligodendroglioma: an analysis of 42 cases. J Neurol Neurosurg Psychiat 50: 304–312, 1987

    Google Scholar 

  36. Iglesias JR, Karner E, Aruffo C: GFAP immunoreactivity of oligo-astrocytomas. Study of 120 cases. In: Chatel M, Darcel F, Pecker J (eds) Brain Oncology. Martinus Nijhoff Publishers, Dordrecht 1987, pp 41–49

    Google Scholar 

  37. Penfield W: Oligodendroglia and its relation to classical neuroglia. Brain 47: 430–452, 1924

    Google Scholar 

  38. Ravens JR, Adamkiewicz LL, Groff R: Cytology and cellular pathology of the oligodendrogliomas of the brain. J Neuropathol Exp Neurol 14: 142–184, 1955

    Google Scholar 

  39. Rubinstein LJ: Morphological problems of brain tumors with mixed cell populations. Acta Neurochir (Wien) Suppl X: 141–158, 1964

    Google Scholar 

  40. Herpers MJHM, Budka H: Glial fibrillary acidic protein (GFAP) in oligodendroglial tumors: Gliofibrillary oligodendroglioma and transitional oligoastrocytoma as subtypes of oligodendroglioma. Acta Neuropathol 64: 265–272, 1984

    Google Scholar 

  41. Kepes JJ, Meneses ACO: Astrocytic differentiation of neoplastic oligodendrocytes. 11th Int Congr Neuropathol Vienna: 158 [Abstr. D5-11], Sept 1982

  42. Meneses ACO, Kepes JJ, Sternberger NH: Astrocytic differentiation of neoplastic oligodendrocytes. J Neuropathol Exp Neurol 41: 368, 1982 (abstract)

    Google Scholar 

  43. Elasco ME, Dahl D, Roessmann U, Gambetti P: Immunohistochemical localization of glial fibrillary acidic protein in human glial neoplasms. Cancer 45: 484–494, 1980

    Google Scholar 

  44. Bishop MB, de la Monte SM: Dual lineage of astrocytomas. Am J Pathol 135: 517–527, 1989

    Google Scholar 

  45. Choi BH, Kim RC: Expression of glial fibrillary acidic protein in immature oligodendroglia. Science 223: 407–409, 1984

    Google Scholar 

  46. De la Monte SM: Uniform lineage of oligodendrogliomas. Am J Pathol 135: 529–540, 1989

    Google Scholar 

  47. Raff MC, Miller RH, Noble M: A glial progenitor cell that develops in vitrointo an astrocyte or an oligodendrocyte depending on culture medium. Nature 303: 390–396, 1983

    Google Scholar 

  48. Kraus JA, Koopmann J, Kaskel P, Maintz D, Brandner S, Schramm J, Louis DN, Wiestler OD, von Deimling A: Shared allelic losses on chromosomes 1p and 19q suggest a common origin of oligodendroglioma and oligoastrocytoma. J Neuropathol Exp Neurol 54: 91–95, 1995

    Google Scholar 

  49. Noble M: Points of controversy in the O-2A lineage: clocks and type-2 astrocytes. Glia 4: 157–164, 1991

    Google Scholar 

  50. Raff MC: Glial cell diversification in the rat optic nerve. Science 243: 1450–1455, 1989

    Google Scholar 

  51. Gilles FH, Sobel EL, Leviton A, Tavare CJ, Hedley-White ET, and Childhood Brain Tumor Consortium: Histologic feature reliability in childhood neural tumors. J Neuropathol Exp Neurol 53: 559–571, 1994

    Google Scholar 

  52. Kim TS, Halliday AL, Hedley-White ET, Convery K: Correlates of survival and the Daumas-Duport grading system for astrocytomas. J Neurosurg 74: 27–37, 1991

    Google Scholar 

  53. VandenBerg SR: Current diagnostic concepts of astrocytic tumors. J Neuropathol Exp 51: 644–657, 1992

    Google Scholar 

  54. Montironi R, Collan Y, Scarpelli M, Sisti S, Barbatelli G, Carnevali A, Pisani E, Mariuzzi GM: Reproducibility of mitotic counts and identification of mitotic figures in malignant glial tumors. Appl Pathol 6: 258–265, 1988

    Google Scholar 

  55. Paulus W, Peiffer J: Intratumoral histologic heterogeneity of gliomas. A quantitative study. Cancer 64: 442–447, 1989

    Google Scholar 

  56. Allegranza A, Girlando S, Arrigoni GL, Veronese S, Mauri FA, Gambacorta M: Proliferating cell nuclear antigen expression in central nervous system neoplasms. Virchows Arch A Pathol Anat 419: 417–423, 1991

    Google Scholar 

  57. McCormick D, Yu C, Hobbs C: The relevance of antibody concentration to the immunohistological quantification of cell-proliferation-associated antigens. Histopathology 22: 543–547, 1993

    Google Scholar 

  58. McCormick D, Hall PA: The complexities of proliferating cell nuclear antigen. Histopathology 21: 591–594, 1992

    Google Scholar 

  59. Gottschalk J, Goebel S, Jautzke G: Influence of preoperative dexamethasone therapy on proliferating cell nuclear antigen (PCNA) expression in comparison to other parameters in meningiomas. Histol Histopath 7: 653–661, 1992

    Google Scholar 

  60. Giangaspero F, Burger PC: Correlations between cytologic composition and biologic behavior in the glioblastoma multiforme: a postmortem study of 50 cases. Cancer 52: 3220–3233, 1983

    Google Scholar 

  61. Lindegaard K-F, Mork SJ, Eide GE, Halvorsen TB, Hatlevoll R, Solgaard T: Statistical analysis of clinicopathological features, radiotherapy, and survival in 170 cases of oligodendroglioma. J Neurosurg 67: 224–230, 1987

    Google Scholar 

  62. Kros JM, Troost D, Van Eden CG, Van der Werf AJM, Uylings HBM: Oligodendroglioma: a comparison of two grading systems. Cancer 61: 2251–2259, 1988

    Google Scholar 

  63. Soffietti R, Chio A, Giordana MT, Vasario E, Schiffer D: Prognostic factors in well-differentiated cerebral astrocytomas in the adult. Neurosurgery 24: 686–692, 1989

    Google Scholar 

  64. Germano IM, Ito M, Cho KG, Hoshino T, Davis RL, Wilson CB: Correlation between histopathological features and proliferative potential of gliomas. J Neurosurg 70: 701–706, 1989

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University Hospital Utrecht, The Netherlands

    Hendrikus G.J. Krouwer & Ale Algra

  2. Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Hendrikus G.J. Krouwer

  3. Department of Neuropathology, University Hospital Leiden, The Netherlands

    Sjoerd G. van Duinen

  4. Department of Neuropathology, Free University Hospital, Amsterdam, The Netherlands

    Wouter Kamphorst & Paul van der Valk

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  1. Hendrikus G.J. Krouwer
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Krouwer, H.G., Duinen, S.G.v., Kamphorst, W. et al. Oligoastrocytomas: a clinicopathological study of 52 cases. J Neurooncol 33, 223–238 (1997). https://doi.org/10.1023/A:1005731305078

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