Glial Tumors- Review of Literature and Our Institutional Experience
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 8
Abstract
Abstract:Tumors of central nervous system (CNS) constitute 1 to 2% of all malignancies. Among these, Gliomas are most common in adults, whereas in children both astrocytomas and medulloblastomas are common. These tumors carry very poor prognosis. We conducted a retrospective and prospective cohort study of 75 patients who underwent surgery for intracranial gliomas in the department of Neurosurgery, Gandhi Hospital, Secunderabad from May 2011 to June 2017. The retrospective data was collected from Department database for the period May 2011 to October 2015 and prospective from November 2015 to June 2017. Patients age at diagnosis, gender, tumor location and biological behavior and histological characteristics were analyzed. All glial tumors (ICD-10; C70-72) included in 2007 WHO classification of central nervous system tumors were included in this study, and metastatic tumors, bony tumors, pineal tumors, pituitary tumors, embryonal and neuroepithelial tumors and all spine and spinal cord tumors were excluded from the study. Molecular study of these tumors, according to recent 2016 WHO Classification of CNS tumors, could not be done due to limited resources in our institute. We analyzed 75 cases of glial tumors operated in Gandhi hospital. Out of these 75 cases, pilocytic astrocytoma were 9, pleomorphic xanthoastrocytoma was one, diffuse astrocytoma were 14, gemistocytic astrocytoma were 2, oligodendroglioma were 4, oligoastrocytoma were 3, anaplastic astrocytoma were 21, anaplastic oligodendroglioma were 3, anaplastic oligoastrocytoma were 2, and glioblastoma were 16. Male dominance was observed in astrocytomas and oligodendrogliomas, and female predominance was observed in pilocyticastrocytomas and anaplastic oligodendrogliomas. Glioblastoma showed equal sex distribution. Most of the WHO grade I tumors were seen in 0-19 years and 20-44 years age groups, WHO grade II tumors were seen in 20-44, 45-54, and 55-64 years age groups, WHO grade III tumors were seen in 20-44 years and 55-64 years age groups and WHO grade IV tumors were seen in 20-44 and 55-64 years age group. Most common initial presentation of glial tumors is headache (33.3%), followed by seizures (25.3), somatosensory loss (21.3%) and motor weakness (20%). Mean duration of illness in low grade gliomas is 10.96 days and in high grade gliomas is 15.5 days. Molecular profiling of gliomas in 2016 WHO classification helps in tumor grading and prognostication beyond histological classification. But many institutions in developing countries have some barriers for molecular and genetic analysis of these distinct brain tumors. However, despite the explosion of molecular era in recent years, we face many challenges in accurately prognosticating and assigning treatment regimes, because of the heterogeneous nature of these gliomas. In future, the use of combined histopathological and molecular criteria coupled with genetic analysis will facilitate the clinical, experimental and epidemiological studies that will lower the mortality and morbidity of patients with glial tumors. Keywords:Glial tumors, Isocitrate dehydrogenase, Astrocytoma, Oligodendroglioma, Glioblastomamultiforme
Authors and Affiliations
SreedharalaSrinivasa Satynarayana, Palukuri Lakshmi, UdayGoutam Nookathota, Alluri Neeraja
Keywords
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