CoChat
Sign Up
Cited by 70Glioma Diagnosis and TreatmentCancer survivorship and carePalliative Care and End-of-Life Issues

Overview of prognostic factors in adult gliomas

Open access
Sharma, Akanksha, Graber, Jerome J.·2021·Annals of Palliative Medicine
DOI 10.21037/apm-20-640
Open this paper in CoChat — free accountOpen PDF

Abstract

Gliomas represent the majority of malignant central nervous system tumors, with the most aggressive subtype, glioblastoma, accounting for almost 57% of this entity. Type of glioma and its incidence can vary depending on the age of presentation. In turn, outcomes can vary significantly based on the actual type of glioma (histologically and molecularly) and age of the patient, as well as various tumor specific factors such as size, location, comorbidities, etc. In the last decade we have been able to identify key molecular features that have provided us with greater insight into the behavior of these tumors, but the spectrum of treatment options remains limited. In addition, ultimate causes of death in patients with gliomas are variable and stochastic in nature. Given these complicated factors, prognostication for gliomas remains extremely difficult. This review aims to discuss prognostication in low grade versus high grade gliomas, variability in treatment of these tumors, clinical features of poor prognosis, and differences in prognostic understanding between patients, caregivers, and providers. We will also make some general recommendations where appropriate on how to approach this subject from a palliative care perspective.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.21037/apm-20-640

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The prognosis of glioma remains poor despite advances in treatment strategies and surgical interventions.

    “Despite advances in treatment strategies and surgical interventions, the diagnosis and overall survival of glioma patients remain poor [22].”

    From miR-21 as a diagnostic and prognostic biomarker in glioma: tissue and serum expression analysis in a Pakistani cohort (2026) · cites this paper as [22]

    The High grade glioma section (page unavailable) says that treatment research has not dramatically changed survival and that grade IV astrocytoma survival remains 16–22 months despite surgical resection being standard care. The claim extends that poor-survival assessment to glioma patients generally, whereas the Survival and prognostication section reports substantially variable survival for low-grade glioma. The paper also discusses difficulty predicting outcomes, not that diagnosis itself remains poor. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 59

  1. Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016;131:803-20.
  2. Silbergeld DL, Rostomily RC, Alvord EC. The cause of death in patients with glioblastoma is multifactorial: clinical factors and autopsy findings in 117 cases of supratentorial glioblastoma in adults. J Neurooncol 1991;10:179-85.
  3. Sveinsson O, Andersson T, Mattsson P, et al. Clinical risk factors in SUDEP: A nationwide population-based case- control study. Neurology 2020;94:e419-29.
  4. Ostrom QT, Gittleman H, Truitt G, et al. CBTRUS © Annals of Palliative Medicine. All rights reserved. Ann Palliat Med 2021;10(1):863-874 | http://dx.doi.org/10.21037/apm-20-640 Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2011-2015. Neuro Oncol 2018;20:iv1-86. · DOI
  5. Jakola AS, Skjulsvik AJ, Myrmel KS, et al. Surgical resection versus watchful waiting in low-grade gliomas. Ann Oncol 2017;28:1942-8.
  6. Aghi MK, Nahed BV, Sloan AE, et al. The role of surgery in the management of patients with diffuse low grade glioma: A systematic review and evidence-based clinical practice guideline. J Neurooncol 2015;125:503-30.
  7. Buckner JC, Shaw EG, Pugh SL, et al. Radiation plus Procarbazine, CCNU, and Vincristine in Low-Grade Glioma. N Engl J Med 2016;374:1344-55.
  8. Hottinger AF, Hegi ME, Baumert BG. Current management of low-grade gliomas. Curr Opin Neurol 2016;29:782-8.
  9. Claus EB, Black PM. Survival rates and patterns of care for patients diagnosed with supratentorial low-grade gliomas: data from the SEER program, 1973-2001. Cancer 2006;106:1358-63.
  10. Soffietti R, Baumert BG, Bello L, et al. Guidelines on management of low-grade gliomas: report of an EFNS- EANO Task Force. Eur J Neurol 2010;17:1124-33.
  11. Pignatti F, van den Bent M, Curran D, et al. Prognostic factors for survival in adult patients with cerebral low- grade glioma. J Clin Oncol 2002;20:2076-84.
  12. Gorlia T, Wu W, Wang M, et al. 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. Neuro Oncol 2013;15:1568-79.
  13. Smits A, Jakola AS. Clinical Presentation, Natural History, and Prognosis of Diffuse Low-Grade Gliomas. Neurosurg Clin N Am. 2019;30(1):35-42.
  14. Pallud J, Capelle L, Taillandier L, et al. Prognostic significance of imaging contrast enhancement for WHO grade II gliomas. Neuro Oncol 2009;11:176-82.
  15. Waqar M, Hanif S, Brodbelt AR, et al. Prognostic Factors in Lobar World Health Organization Grade II Astrocytomas. World Neurosurg 2015;84:154-62.
  16. Chang EF, Smith JS, Chang SM, et al. Preoperative prognostic classification system for hemispheric low-grade gliomas in adults. J Neurosurg 2008;109:817-24.
  17. Daniels TB, Brown PD, Felten SJ, et al. Validation of EORTC prognostic factors for adults with low-grade glioma: a report using intergroup 86-72-51. Int J Radiat Oncol Biol Phys 2011;81:218-24.
  18. Pallud J, Audureau E, Blonski M, et al. Epileptic seizures in diffuse low-grade gliomas in adults. Brain 2014;137:449-62.
  19. Ostrom QT, Cote DJ, Ascha M, et al. Adult Glioma Incidence and Survival by Race or Ethnicity in the United States From 2000 to 2014. JAMA Oncol 2018;4:1254-62.
  20. Houillier C, Wang X, Kaloshi G, et al. IDH1 or IDH2 mutations predict longer survival and response to temozolomide in low-grade gliomas. Neurology 2010;75:1560-6.
  21. Baumert BG, Hegi ME, van den Bent MJ, et al. Temozolomide chemotherapy versus radiotherapy in high-risk low-grade glioma (EORTC 22033-26033): a randomised, open-label, phase 3 intergroup study. Lancet Oncol 2016;17:1521-32.
  22. Smith JS, Perry A, Borell TJ, et al. Alterations of chromosome arms 1p and 19q as predictors of survival in oligodendrogliomas, astrocytomas, and mixed oligoastrocytomas. J Clin Oncol 2000;18:636-45.
  23. Cimino PJ, Holland EC. Targeted copy number analysis outperforms histologic grading in predicting patient survival for WHO grades II/III IDH-mutant astrocytomas. Neuro Oncol 2019;21:819-21.
  24. Eckel-Passow JE, Lachance DH, Molinaro AM, et al. Glioma Groups Based on 1p/19q, IDH, and TERT Promoter Mutations in Tumors. N Engl J Med. 2015;372:2499-508.
  25. Wiestler B, Capper D, Holland-Letz T, et al. ATRX loss refines the classification of anaplastic gliomas and identifies a subgroup of IDH mutant astrocytic tumors with better prognosis. Acta Neuropathol 2013;126:443-51.
  26. Alexander BM, Cloughesy TF. Adult Glioblastoma. J Clin Oncol 2017;35:2402-9.
  27. Trifiletti DM, Alonso C, Grover S, et al. Prognostic Implications of Extent of Resection in Glioblastoma: Analysis from a Large Database. World Neurosurg 2017;103:330-40.
  28. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352:987-96.
  29. Perry JR, Laperriere N, O'Callaghan CJ, et al. Short- Course Radiation plus Temozolomide in Elderly Patients with Glioblastoma. N Engl J Med 2017;376:1027-37.
  30. Hegi ME, Diserens AC, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005;352:997-1003.
  31. Cairncross G, Wang M, Shaw E, et al. Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol 2013;31:337-43.
  32. Stupp R, Taillibert S, Kanner AA, et al. Maintenance Therapy With Tumor-Treating Fields Plus Temozolomide vs Temozolomide Alone for Glioblastoma: A Randomized Clinical Trial. JAMA 2015;314:2535-43.
  33. Scott JN, Rewcastle NB, Brasher PM, et al. Which glioblastoma multiforme patient will become a long- term survivor? A population-based study. Ann Neurol 1999;46:183-8.
  34. Chaudhry NS, Shah AH, Ferraro N, et al. Predictors of long-term survival in patients with glioblastoma multiforme: advancements from the last quarter century. Cancer Invest. 2013;31:287-308.
  35. Heiland DH, Haaker G, Watzlawick R, et al. One decade of glioblastoma multiforme surgery in 342 elderly patients: what have we learned? J Neurooncol 2018;140:385-91.
  36. Tsang DS, Khan L, Perry JR, et al. Survival outcomes in elderly patients with glioblastoma. Clin Oncol (R Coll Radiol) 2015;27:176-83.
  37. Millward CP, Brodbelt AR, Haylock B, et al. The impact of MGMT methylation and IDH-1 mutation on long-term outcome for glioblastoma treated with chemoradiotherapy. Acta Neurochir (Wien) 2016;158:1943-53.
  38. Arita H, Yamasaki K, Matsushita Y, et al. A combination of TERT promoter mutation and MGMT methylation status predicts clinically relevant subgroups of newly diagnosed glioblastomas. Acta Neuropathol Commun 2016;4:79.
  39. Stichel D, Ebrahimi A, Reuss D, et al. Distribution of EGFR amplification, combined chromosome 7 gain and chromosome 10 loss, and TERT promoter mutation in brain tumors and their potential for the reclassification of IDHwt astrocytoma to glioblastoma. Acta Neuropathol 2018;136:793-803.
  40. Cimino PJ, McFerrin L, Wirsching HG, et al. Copy number profiling across glioblastoma populations has implications for clinical trial design. Neuro Oncol 2018;20:1368-73.
  41. Woroniecka KI, Rhodin KE, Chongsathidkiet P, et al. T-cell Dysfunction in Glioblastoma: Applying a New Framework. Clin Cancer Res 2018;24:3792-802.
  42. Grossman SA, Ye X, Lesser G, et al. Immunosuppression in patients with high-grade gliomas treated with radiation and temozolomide. Clin Cancer Res 2011;17:5473-80.
  43. Johnston SK, Whitmire P, Massey SC, et al. ENvironmental Dynamics Underlying Responsive Extreme Survivors (ENDURES) of Glioblastoma: A Multidisciplinary Team-based, Multifactorial Analytical Approach. Am J Clin Oncol 2019;42:655-61.
  44. Johnson DR, Ma DJ, Buckner JC, et al. Conditional probability of long-term survival in glioblastoma: a population-based analysis. Cancer 2012;118:5608-13.
  45. Smoll NR, Schaller K, Gautschi OP. Long-term survival of patients with glioblastoma multiforme (GBM). J Clin Neurosci 2013;20:670-5.
  46. Abe H, Natsumeda M, Okada M, et al. MGMT Expression Contributes to Temozolomide Resistance in H3K27M-Mutant Diffuse Midline Gliomas. Front Oncol 2020;9:1568.
  47. Chi AS, Tarapore RS, Hall MD, et al. Pediatric and adult H3 K27M-mutant diffuse midline glioma treated with the selective DRD2 antagonist ONC201. J Neurooncol 2019;145:97-105.
  48. Pratt D, Natarajan SK, Banda A, et al. Circumscribed/non- diffuse histology confers a better prognosis in H3K27M- mutant gliomas. Acta Neuropathol 2018;135:299-301.
  49. Mantia C, Zwicker JI. Anticoagulation in the Setting of Primary and Metastatic Brain Tumors. Cancer Treat Res 2019;179:179-89.
  50. Chaichana KL, Parker SL, Olivi A, et al. Long-term seizure outcomes in adult patients undergoing primary resection of malignant brain astrocytomas. Clinical article. J Neurosurg 2009;111:282-92.
  51. Lote K, Egeland T, Hager B , et al. Survival, prognostic factors, and therapeutic efficacy in low-grade glioma: a retrospective study in 379 patients. J Clin Oncol 1997;15:3129-40.
  52. Hohwieler Schloss M, Freidberg SR, Heatley GJ, et al. Glucocorticoid dependency as a prognostic factor in radiotherapy for cerebral gliomas. Acta Oncol 1989;28:51-5.
  53. Diamond EL, Prigerson HG, Correa DC, et al. Prognostic awareness, prognostic communication, and cognitive function in patients with malignant glioma. Neuro Oncol 2017;19:1532-41.
  54. Applebaum AJ, Buda K, Kryza-Lacombe M, et al. Prognostic awareness and communication preferences among caregivers of patients with malignant glioma. © Annals of Palliative Medicine. All rights reserved. Ann Palliat Med 2021;10(1):863-874 | http://dx.doi.org/10.21037/apm-20-640 Psychooncology 2018;27:817-23. · DOI
  55. Christakis NA, Lamont EB. Extent and determinants of error in doctors' prognoses in terminally ill patients: prospective cohort study. BMJ 2000;320:469-72.
  56. Lobb EA, Halkett GK, Nowak AK. Patient and caregiver perceptions of communication of prognosis in high grade glioma. J Neurooncol 2011;104:315-22.
  57. Salander P, Bergenheim T, Henriksson R. The creation of protection and hope in patients with malignant brain tumours. Soc Sci Med 1996;42:985-96.
  58. Diamond EL, Corner GW, De Rosa A, et al. Prognostic awareness and communication of prognostic information in malignant glioma: a systematic review. J Neurooncol 2014;119:227-34.
  59. Rosenblum ML, Kalkanis S, Goldberg W, et al. Odyssey of hope: a physician's guide to communicating with brain tumor patients across the continuum of care. J Neurooncol 2009;92:241-51.

Cited by

Sorted by citations

Authors
Sharma, A., & Graber, J. J.
Affiliations
  • University of Washington Medical Center (US)
  • University of Washington (US)
Corresponding author
Sharma, Akanksha
ORCID
Venue
Annals of Palliative Medicine
Publisher
AME Publishing Company
Published
2021-01
Volume
10
Issue
1
Pages
863-874
ISSN
  • 2224-5820 (ISSN-L)
  • 2224-5839
DOI
10.21037/apm-20-640
OpenAlex
W3047968167
Cited by
70
References
1
Citations by year
2026: 5 · 2025: 11 · 2024: 16 · 2023: 19 · 2022: 14 · 2021: 4 · 2020: 1
FWCI
1.40
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Annals of Palliative Medicine (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Keywords
glioma, prognostic factors, glioblastoma, low-grade glioma, high-grade glioma, molecular features, treatment options, poor prognosis, palliative care, prognosis communication, central nervous system tumors
MeSH terms
Adult, Brain Neoplasms, Glioblastoma, Glioma, Humans, Prognosis

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review