Prognosis

Prognosis varies depending on the type, grade, and location of the tumor.

Circumscribed astrocytic gliomas

Pilocytic astrocytoma is associated with excellent long-term prognosis. Progression correlates with residual tumor and local recurrence. Survival rates at 5 years of 95% to 100% have been reported in children, and decline with increasing age.[87][88]

Patients with pleomorphic xanthoastrocytoma and subependymal giant cell astrocytoma also have excellent long-term prognosis.

Diffuse infiltrating gliomas

Diffuse gliomas have a high recurrence rate because of their invasiveness of the adjacent brain tissue and resistance to therapy. Prognostic factors include tumor grade, patient age, molecular markers (e.g., isocitrate dehydrogenase [IDH] mutations and 1p/19q codeletion as disease-defining markers; MGMT promoter methylation), and clinical functional status.[3][8][23][27][89] Reported values for median overall survival are as follows:

  • Oligodendroglioma, IDH-mutant, 1p/19q codeleted, grade 2: >14 years

  • Oligodendroglioma, IDH-mutant, 1p/19q codeleted, grade 3: 10-14 years

  • Diffuse astrocytoma, IDH-mutant, grade 2: >10 years

  • Diffuse astrocytoma, IDH-mutant, grade 3: 5-10 years

  • Diffuse astrocytoma, IDH-mutant, grade 4: approximately 3 years

  • Glioblastoma, IDH-wildtype, MGMT promoter methylated : 22-24 months

  • Glioblastoma, IDH-wildtype, MGMT promoter unmethylated: 15-18 months

  • Diffuse midline glioma, H3 K27M-altered: 10-16 months.

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