Glioma natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Common complications of glioma include brain herniation, hydrocephalus, coma, metastasis, recurrence, side effects of chemotherapy, and side effects of radiation therapy. The prognosis of glioma varies with the grade of tumor. The 1-year and 2-year survival rate of patients with malignant glioma is approximately 50% and 25%, respectively.^[1]

Common complications of glioma include:

• Brain herniation
• Hydrocephalus
• Coma
• Metastasis
• Recurrence
• Side effects of chemotherapy
• Side effects of radiation therapy

• The prognosis of glioma varies with the grade of tumor: WHO grade 1 and WHO grade 4 have the most favorable and worst prognosis, respectively.
• The 1-year and 2-year survival rate of patients with malignant glioma is approximately 50% and 25%, respectively.
• Post-operative radiation therapy is often used as an adjunct to surgery in the treatment of high-grade gliomas as it has shown to double the median survival for high-grade gliomas to 37 weeks (versus 17 weeks with surgery alone).
• The prognosis of glioma may depend on other factors which include:^[1]

• Location of the tumor (brain or spinal cord)
• Resectability
• Primary diagnosis vs. recurrence
• Specific mutations:

• DNA methylation of the O6-methylguanine-DNA methyltransferase (MGMT) gene promoter
• Mutation of isocitrate dehydrogenase: IDH1 or IDH2 genes
• Codeletion of chromosomes 1p and 19q