New validated prognostic models and prognostic calculators in patients with low-grade gliomas diagnosed by central pathology review: a pooled analysis of EORTC/RTOG/NCCTG phase III clinical trials
New validated prognostic models and prognostic calculators in patients with low-grade gliomas diagnosed by central pathology review: a pooled analysis of EORTC/RTOG/NCCTG phase III clinical trials
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DOI：
10.1093/neuonc/not117
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发表时间：
2013-11-01
期刊：
影响因子：
15.9
通讯作者：
van den Bent, Martin J.
中科院分区：
文献类型：
--
作者：
Gorlia, Thierry;Wu, Wenting;van den Bent, Martin J.
在之前的一项研究中，欧洲癌症研究和治疗组织（EORTC）报告了一种预测低级别胶质瘤（LGG）患者生存率的评分系统。脑肿瘤诊断中的一个主要问题是病理学家之间缺乏一致性。本研究利用339例经中心病理学复查确诊的EORTC患者的数据，建立了新的无进展生存期（PFS）和总生存期（OS）的预后模型。从450例集中诊断LGGs招募到2个大型研究的北美合作组的数据被用来验证models.Both PFS和OS的存在的基线神经功能缺损，较短的时间，首次症状（30周），星形细胞肿瘤类型，肿瘤直径大于5厘米的负面影响。早期放疗改善PFS，但OS。三个风险组已被确定（低，中，高）和validated.We开发了新的预后模型，在一个更同质的LGG人口诊断的中央病理审查。该人群更符合现代实践，其中患者基于中心或小组病理学审查入组临床试验。我们可以在一个大型的、外部的、独立的数据集中验证模型。该模型可以将LGG患者分为3个风险组，并提供可靠的个体生存预测。纳入其他临床和分子因素仍可能改善模型预测。
In a previous study, the European Organisation for Research and Treatment of Cancer (EORTC) reported a scoring system to predict survival of patients with low-grade gliomas (LGGs). A major issue in the diagnosis of brain tumors is the lack of agreement among pathologists. New models in patients with LGGs diagnosed by central pathology review are needed.Data from 339 EORTC patients with LGGs diagnosed by central pathology review were used to develop new prognostic models for progression-free survival (PFS) and overall survival (OS). Data from 450 patients with centrally diagnosed LGGs recruited into 2 large studies conducted by North American cooperative groups were used to validate the models.Both PFS and OS were negatively influenced by the presence of baseline neurological deficits, a shorter time since first symptoms (30 wk), an astrocytic tumor type, and tumors larger than 5 cm in diameter. Early irradiation improved PFS but not OS. Three risk groups have been identified (low, intermediate, and high) and validated.We have developed new prognostic models in a more homogeneous LGG population diagnosed by central pathology review. This population better fits with modern practice, where patients are enrolled in clinical trials based on central or panel pathology review. We could validate the models in a large, external, and independent dataset. The models can divide LGG patients into 3 risk groups and provide reliable individual survival predictions. Inclusion of other clinical and molecular factors might still improve models predictions.