| Objective To investigate prognostic factors for survival in patients who had low grade gliomas harboring brain eloquent areas.Methods Retrospectively analyzed the clinical datas of 62 patients with low grade glioma harboring eloquent areas,which were newly diagnosed by the Department of Neurosurgery,the First Affiliated Hospital of Anhui Medical University from January2011 to June 2015.They were mainly grade II astrocytoma,oligodendroglioma,mixed oligodendrocyte-astrocytoma,and imaginges showed that the tumors were located in the functional area(language,exercise and sensory areas of the cortex and subcortical pathway).11 clinical factors were counted for this study,which were age,sex,initial symptom,symptom onset to operation time,number of lobes involved,maximum diameter of tumor,preoperative KPS score,degree of surgical resection,pathological type,postoperative new dysfunction,postoperative radiotherapy and chemotherapy.This study used software SPSS 17.0 for statistical analysis.univariate analysis of survival factors was carried out by Kaplan-Meier method,and progression-free survival(PFS)and total survival(OS)were compared using Log-Rank test.At last,significant indicators were included in the Cox proportional hazards model for multivariate analysis with P <0.05 for a statistically significant difference.Result Kaplan-Meier method was used to analyze the clinical factors of 62 newly diagnosed low-grade gliomas harboring eloquent areas.According to age grouped,<40years old 31 cases,≥ 40 years old 31 cases,the mean PFS was 46.6 months and 30.3 months(P = 0.001).and the mean OS was 47.5 months and 31.3 months(P = 0.001).According to sex grouped,31 males and 31 females,the average PFS in the two groups was 35.9 months and 41.1 months(P = 0.259),while the average OS were 38.8 months and 41.2 months(P = 0.411).According to whether the initial symptom of epilepsy grouped,epilepsy in 14 cases,48 cases of non-epilepsy,the average PFS in the two groups was 37.6 months and 43.4 months(P = 0.818),then the average OS was 39.7months and 44.7 months(P = 0.399).According to symptoms to the operation time grouped,,<6 months in 42 cases,≥6 months in 20 cases,the average PFS of the two groups was 37.6 months and 43.4 months(P = 0.818).while the average OS was 39.7months and 44.7 months(P = 0.399).According to the number of lobes involved grouped,35 cases of single lobes,27 cases of multilobes,the average PFS of the two groups was41.2 months and 36.3 months(P = 0.430).while the average OS was 43.6 months and37.5 months(P = 0.345).According to the maximum diameter of the tumor grouped,<6cm in 36 cases,≥6cm in 26 cases,the average PFS of the two groups was 39.5 months and 38.8 months(P = 0.734),then the average OS of the two groups was 41.6 months and40.4 months(P = 0.876).According to preoperative KPS scores grouped,KPS ≥70 scores in 49 cases,KPS <70 scores in 13 cases,the average PFS was 42.1 months and 26.1months(P = 0.019),respectively,while the average OS of the two groups was 44.3months and 29.7 months(P = 0.027).According to the extent of resection grouped,total resction in 39 cases,subtotal resction in 23 cases,the average PFS was 45.0 months and27.0 months(P = 0.001),respectively,then the average OS of the two groups was 47.4months and 30.3 months(P = 0.001).According to the pathological type of tumor grouped,oligodendrocytoma in 31 cases,astrocytoma in 22 cases,mixed oligodendrocyte-astrocytoma in 9 cases,the average PFS of the three groups was 48.1months,25.4 months and 26.2 months(P = 0.001).and the average OS was 50.5 months,27.0 months and 28.0 months respectively(P <0.001).The PFS and OS of patients with oligodendroglioma were significantly better than those of mixed oligodendrocytes-astrocytomas and astrocytomas,and there was no significant difference between the latter two types.According to whether new postoperative dysfunction grouped,26 cases of new postoperative dysfunction,36 cases had not,the average PFS was 40.0 months and 37.8 months(P = 0.706),with an average OS of 41.2 months and 40.6 months respectively(P = 0.778).According to whether accepted radiotherapy and chemotherapy postoperative,patients were divided into radiotherapy combined with chemotherapy group,radiotherapy group,chemotherapy group,neither radiotherapy nor chemotherapy group,the average PFS was 44.1 months,26.2 months,43.3 months and 21.8 months respectively(P <0.001),with an average OS of 44.8 months,29.0 months,43.8 months and 25.3 months(P = 0.001).Mutivariate analysis showed that age,preoperative KPS score,EOR,histological subtype were independenet predictors in improving PFS and OS.Conclusions The PFS and OS of patients with older age(≥ 40 years old),high preoperative KPS score(≥70 points),and astrocytoma componets were shorter than that of patients with age<40 years old,preoperative KPS score ≥70 points,pathological type of oligodendroglioma;furthermore,surgical total resection and postoperative radio-chemotherapy could prolong the survival of patients. |
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