Extent of resection and survival for oligodendroglioma: a U.S. population-based study

Connor J. Kinslow, Andrew L.A. Garton, Ali I. Rae, Logan P. Marcus, Christopher M. Adams, Guy M. McKhann, Michael B. Sisti, E. Sander Connolly, Jeffrey N. Bruce, Alfred I. Neugut, Adam M. Sonabend, Peter Canoll, Simon K. Cheng, Tony J.C. Wang*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: National guidelines recommend maximal safe resection of low-grade and high-grade oligodendrogliomas. However, there is no level 1 evidence to support these guidelines, and recent retrospective studies on the topic have yielded mixed results. Objective: To assess the association between extent of resection (EOR) and survival for oligodendrogliomas in the general U.S. population. Methods: Cases diagnosed between 2004 and 2013 were selected from the Surveillance, Epidemiology, and End-Results (SEER) Program and retrospectively analyzed for treatment, prognostic factors, and survival times. Cases that did not undergo tumor de-bulking surgery (e.g. no surgery or biopsy alone) were compared to subtotal resection (resection) and gross-total resection (GTR). The primary end-points were overall survival (OS) and cause-specific survival (CSS). An external validation cohort with 1p/19q-codeleted tumors was creating using the TCGA and GSE16011 datasets. Results: 3135 Cases were included in the final analysis. The 75% survival time (75ST) and 5-year survival rates were 47 months and 70.8%, respectively. Subtotal resection (STR, 75ST = 50 months) and GTR (75ST = 61 months) were associated with improved survival times compared to cases that did not undergo surgical debulking (75ST = 20 months, P < 0.001 for both), with reduced hazard ratios (HRs) after controlling for other factors (HR 0.81 [0.68–0.97] and HR 0.65 [0.54–0.79], respectively). GTR was associated with improved OS in both low-grade and anaplastic oligodendroglioma subgroups (HR 0.74 [0.58–0.95], HR 0.60 [0.44–0.82], respectively) while STR fell short of significance in the subgroup analysis. All findings were corroborated by multivariable analysis of CSS and externally validated in a cohort of patients with 1p19q-codeleted tumors. Conclusion: Greater EOR is associated with improved survival in oligodendrogliomas. Our findings in this U.S. population-based cohort support national guidelines.

Original languageEnglish (US)
Pages (from-to)591-601
Number of pages11
JournalJournal of Neuro-Oncology
Volume144
Issue number3
DOIs
StatePublished - Sep 1 2019

Fingerprint

Oligodendroglioma
Survival
Population
Guidelines
SEER Program
Neoplasms

Keywords

  • Extent of resection
  • Gross-total resection
  • Oligodendroglioma
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Kinslow, C. J., Garton, A. L. A., Rae, A. I., Marcus, L. P., Adams, C. M., McKhann, G. M., ... Wang, T. J. C. (2019). Extent of resection and survival for oligodendroglioma: a U.S. population-based study. Journal of Neuro-Oncology, 144(3), 591-601. https://doi.org/10.1007/s11060-019-03261-5
Kinslow, Connor J. ; Garton, Andrew L.A. ; Rae, Ali I. ; Marcus, Logan P. ; Adams, Christopher M. ; McKhann, Guy M. ; Sisti, Michael B. ; Connolly, E. Sander ; Bruce, Jeffrey N. ; Neugut, Alfred I. ; Sonabend, Adam M. ; Canoll, Peter ; Cheng, Simon K. ; Wang, Tony J.C. / Extent of resection and survival for oligodendroglioma : a U.S. population-based study. In: Journal of Neuro-Oncology. 2019 ; Vol. 144, No. 3. pp. 591-601.
@article{f2c11a96cb184f67a6272e9d9e2f8803,
title = "Extent of resection and survival for oligodendroglioma: a U.S. population-based study",
abstract = "Background: National guidelines recommend maximal safe resection of low-grade and high-grade oligodendrogliomas. However, there is no level 1 evidence to support these guidelines, and recent retrospective studies on the topic have yielded mixed results. Objective: To assess the association between extent of resection (EOR) and survival for oligodendrogliomas in the general U.S. population. Methods: Cases diagnosed between 2004 and 2013 were selected from the Surveillance, Epidemiology, and End-Results (SEER) Program and retrospectively analyzed for treatment, prognostic factors, and survival times. Cases that did not undergo tumor de-bulking surgery (e.g. no surgery or biopsy alone) were compared to subtotal resection (resection) and gross-total resection (GTR). The primary end-points were overall survival (OS) and cause-specific survival (CSS). An external validation cohort with 1p/19q-codeleted tumors was creating using the TCGA and GSE16011 datasets. Results: 3135 Cases were included in the final analysis. The 75{\%} survival time (75ST) and 5-year survival rates were 47 months and 70.8{\%}, respectively. Subtotal resection (STR, 75ST = 50 months) and GTR (75ST = 61 months) were associated with improved survival times compared to cases that did not undergo surgical debulking (75ST = 20 months, P < 0.001 for both), with reduced hazard ratios (HRs) after controlling for other factors (HR 0.81 [0.68–0.97] and HR 0.65 [0.54–0.79], respectively). GTR was associated with improved OS in both low-grade and anaplastic oligodendroglioma subgroups (HR 0.74 [0.58–0.95], HR 0.60 [0.44–0.82], respectively) while STR fell short of significance in the subgroup analysis. All findings were corroborated by multivariable analysis of CSS and externally validated in a cohort of patients with 1p19q-codeleted tumors. Conclusion: Greater EOR is associated with improved survival in oligodendrogliomas. Our findings in this U.S. population-based cohort support national guidelines.",
keywords = "Extent of resection, Gross-total resection, Oligodendroglioma, Surgery",
author = "Kinslow, {Connor J.} and Garton, {Andrew L.A.} and Rae, {Ali I.} and Marcus, {Logan P.} and Adams, {Christopher M.} and McKhann, {Guy M.} and Sisti, {Michael B.} and Connolly, {E. Sander} and Bruce, {Jeffrey N.} and Neugut, {Alfred I.} and Sonabend, {Adam M.} and Peter Canoll and Cheng, {Simon K.} and Wang, {Tony J.C.}",
year = "2019",
month = "9",
day = "1",
doi = "10.1007/s11060-019-03261-5",
language = "English (US)",
volume = "144",
pages = "591--601",
journal = "Journal of Neuro-Oncology",
issn = "0167-594X",
publisher = "Kluwer Academic Publishers",
number = "3",

}

Kinslow, CJ, Garton, ALA, Rae, AI, Marcus, LP, Adams, CM, McKhann, GM, Sisti, MB, Connolly, ES, Bruce, JN, Neugut, AI, Sonabend, AM, Canoll, P, Cheng, SK & Wang, TJC 2019, 'Extent of resection and survival for oligodendroglioma: a U.S. population-based study', Journal of Neuro-Oncology, vol. 144, no. 3, pp. 591-601. https://doi.org/10.1007/s11060-019-03261-5

Extent of resection and survival for oligodendroglioma : a U.S. population-based study. / Kinslow, Connor J.; Garton, Andrew L.A.; Rae, Ali I.; Marcus, Logan P.; Adams, Christopher M.; McKhann, Guy M.; Sisti, Michael B.; Connolly, E. Sander; Bruce, Jeffrey N.; Neugut, Alfred I.; Sonabend, Adam M.; Canoll, Peter; Cheng, Simon K.; Wang, Tony J.C.

In: Journal of Neuro-Oncology, Vol. 144, No. 3, 01.09.2019, p. 591-601.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Extent of resection and survival for oligodendroglioma

T2 - a U.S. population-based study

AU - Kinslow, Connor J.

AU - Garton, Andrew L.A.

AU - Rae, Ali I.

AU - Marcus, Logan P.

AU - Adams, Christopher M.

AU - McKhann, Guy M.

AU - Sisti, Michael B.

AU - Connolly, E. Sander

AU - Bruce, Jeffrey N.

AU - Neugut, Alfred I.

AU - Sonabend, Adam M.

AU - Canoll, Peter

AU - Cheng, Simon K.

AU - Wang, Tony J.C.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Background: National guidelines recommend maximal safe resection of low-grade and high-grade oligodendrogliomas. However, there is no level 1 evidence to support these guidelines, and recent retrospective studies on the topic have yielded mixed results. Objective: To assess the association between extent of resection (EOR) and survival for oligodendrogliomas in the general U.S. population. Methods: Cases diagnosed between 2004 and 2013 were selected from the Surveillance, Epidemiology, and End-Results (SEER) Program and retrospectively analyzed for treatment, prognostic factors, and survival times. Cases that did not undergo tumor de-bulking surgery (e.g. no surgery or biopsy alone) were compared to subtotal resection (resection) and gross-total resection (GTR). The primary end-points were overall survival (OS) and cause-specific survival (CSS). An external validation cohort with 1p/19q-codeleted tumors was creating using the TCGA and GSE16011 datasets. Results: 3135 Cases were included in the final analysis. The 75% survival time (75ST) and 5-year survival rates were 47 months and 70.8%, respectively. Subtotal resection (STR, 75ST = 50 months) and GTR (75ST = 61 months) were associated with improved survival times compared to cases that did not undergo surgical debulking (75ST = 20 months, P < 0.001 for both), with reduced hazard ratios (HRs) after controlling for other factors (HR 0.81 [0.68–0.97] and HR 0.65 [0.54–0.79], respectively). GTR was associated with improved OS in both low-grade and anaplastic oligodendroglioma subgroups (HR 0.74 [0.58–0.95], HR 0.60 [0.44–0.82], respectively) while STR fell short of significance in the subgroup analysis. All findings were corroborated by multivariable analysis of CSS and externally validated in a cohort of patients with 1p19q-codeleted tumors. Conclusion: Greater EOR is associated with improved survival in oligodendrogliomas. Our findings in this U.S. population-based cohort support national guidelines.

AB - Background: National guidelines recommend maximal safe resection of low-grade and high-grade oligodendrogliomas. However, there is no level 1 evidence to support these guidelines, and recent retrospective studies on the topic have yielded mixed results. Objective: To assess the association between extent of resection (EOR) and survival for oligodendrogliomas in the general U.S. population. Methods: Cases diagnosed between 2004 and 2013 were selected from the Surveillance, Epidemiology, and End-Results (SEER) Program and retrospectively analyzed for treatment, prognostic factors, and survival times. Cases that did not undergo tumor de-bulking surgery (e.g. no surgery or biopsy alone) were compared to subtotal resection (resection) and gross-total resection (GTR). The primary end-points were overall survival (OS) and cause-specific survival (CSS). An external validation cohort with 1p/19q-codeleted tumors was creating using the TCGA and GSE16011 datasets. Results: 3135 Cases were included in the final analysis. The 75% survival time (75ST) and 5-year survival rates were 47 months and 70.8%, respectively. Subtotal resection (STR, 75ST = 50 months) and GTR (75ST = 61 months) were associated with improved survival times compared to cases that did not undergo surgical debulking (75ST = 20 months, P < 0.001 for both), with reduced hazard ratios (HRs) after controlling for other factors (HR 0.81 [0.68–0.97] and HR 0.65 [0.54–0.79], respectively). GTR was associated with improved OS in both low-grade and anaplastic oligodendroglioma subgroups (HR 0.74 [0.58–0.95], HR 0.60 [0.44–0.82], respectively) while STR fell short of significance in the subgroup analysis. All findings were corroborated by multivariable analysis of CSS and externally validated in a cohort of patients with 1p19q-codeleted tumors. Conclusion: Greater EOR is associated with improved survival in oligodendrogliomas. Our findings in this U.S. population-based cohort support national guidelines.

KW - Extent of resection

KW - Gross-total resection

KW - Oligodendroglioma

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=85070919359&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070919359&partnerID=8YFLogxK

U2 - 10.1007/s11060-019-03261-5

DO - 10.1007/s11060-019-03261-5

M3 - Article

C2 - 31407129

AN - SCOPUS:85070919359

VL - 144

SP - 591

EP - 601

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

SN - 0167-594X

IS - 3

ER -

Kinslow CJ, Garton ALA, Rae AI, Marcus LP, Adams CM, McKhann GM et al. Extent of resection and survival for oligodendroglioma: a U.S. population-based study. Journal of Neuro-Oncology. 2019 Sep 1;144(3):591-601. https://doi.org/10.1007/s11060-019-03261-5