A 10-Year Survival-Trend Analysis of Low-Grade Glioma and Treatment Patterns from an LMIC

Mohammad Hamza Bajwa, Saad Bin Anis, Irfan Yousaf, Mashal Shah
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Abstract

Abstract Objectives The 2021 WHO Classification of Central Nervous System Tumors taxonomy laid further stress on molecular classification and prognostication of glial tumors in comparison to histopathological grading. Research shows that low-grade gliomas (LGGs) can go through malignant differentiation and lead to severe disability and death. Data from various populations will be necessary to ascertain the exact interplay between genotypic predictors of LGG and outcomes. Materials and Methods To assess the molecular pathology for glial tumors in the Pakistani population, the Shaukat Khanum Memorial Cancer Hospital carried out a retrospective chart review of electronic health records from 2008 to 2018, with immunohistochemistry analysis findings from 2010 to 2018. Patients with a pathological diagnosis of a glioma were included. Statistical Analysis Analysis was performed using IBM SPSS Statistics Version 23 and STATA Version 16. A p-value of less than 0.05 was considered statistically significant with 95% confidence intervals reported. Results In all, 281 operable tumors were recorded. The most common procedure was a subtotal resection, and astrocytomas (64.77%) were the most common tumors. Radiation therapy and PCV (procarbazine, CCNU, and vincristine) was received by 85 patients, while radiation therapy and temozolomide were administered to 15 patients. Conclusions Isocitrate dehydrogenase (IDH) wild-type LGG had a lower survival time, while improved survival times were seen for alpha-thalassemia X-linked intellectual disability syndrome (ATRX) retained and 1p19q co-deleted LGGs. Further studies are required to gain a better understanding of lower-grade glial tumor treatment and survival in Pakistan.
低级别胶质瘤的10年生存趋势分析和LMIC治疗模式
与组织病理学分级相比,2021年WHO中枢神经系统肿瘤分类进一步强调神经胶质肿瘤的分子分类和预后。研究表明,低级别胶质瘤(LGGs)可发生恶性分化,导致严重残疾和死亡。为了确定LGG基因型预测因子与预后之间的确切相互作用,需要来自不同人群的数据。为了评估巴基斯坦人群中神经胶质肿瘤的分子病理学,Shaukat Khanum纪念癌症医院对2008年至2018年的电子健康记录进行了回顾性图表审查,并对2010年至2018年的免疫组织化学分析结果进行了分析。包括病理诊断为神经胶质瘤的患者。采用IBM SPSS Statistics Version 23和STATA Version 16进行统计分析。p值小于0.05被认为具有统计学意义,报告95%置信区间。结果共记录可手术肿瘤281例。最常见的手术是次全切除,星形细胞瘤(64.77%)是最常见的肿瘤。85例患者接受放射治疗和PCV(丙卡嗪、CCNU和长春新碱),15例患者接受放射治疗和替莫唑胺。结论异柠檬酸脱氢酶(IDH)野生型LGG存活时间较短,而α -地中海贫血x相关智力残疾综合征(ATRX)保留和1p19q共缺失的LGG存活时间较长。需要进一步的研究来更好地了解巴基斯坦低级别胶质细胞肿瘤的治疗和生存。
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