PROGNOSTIC FACTORS IN GLIOMAS - A MULTIVARIATE-ANALYSIS OF CLINICAL, PATHOLOGICAL, FLOW CYTOMETRIC, CYTOGENETIC, AND MOLECULAR MARKERS

Background. The ability to divide subsets of patients with glial neopl asms into prognostic groups currently is limited because only a few cl inical and pathologic variables are available. The goal of this invest igation was to identify biologic factors of potential prognostic value in patients with cerebral gliomas. Methods. This prospective investig ation used clinical, pathologic, flow cytometric, cytogenetic, and mol ecular genetic variables as potential prognostic factors in 207 patien ts with newly diagnosed gliomas (153 astrocytic tumors of the fibrilla ry type, 31 oligodendrogliomas, and 23 pilocytic astrocytomas). Classi fication and regression tree (CART) analysis was performed as part of the multivariate statistical analysis. Results. The age of the patient and the grade of the tumor were confirmed as strong prognostic factor s. Cytogenetic or molecular genetic abnormalities of chromosomes 7 and 10 were associated with poor survival in univariate analysis (P < 0.0 001). CART multivariate analysis identified several subsets of patient s with different prognoses. In the subset of patients younger than 66. 5 years with Grade 4 tumors, the survival time was longer for those wi th aneuploid tumors than for those with nonaneuploid tumors. In the su bset of patients with Grades 13 tumors, the survival time was longer f or those whose tumors had a %G2M of less than 6.9 than for those whose tumors had a %G2M of 6.9 or greater. Conclusion. This investigation p rovides further evidence that flow cytometry, cytogenetic, and molecul ar genetic factors that may have prognostic value in patients with gli omas can be identified.