Glioma outcome

In order to set up a reliable prediction system for the tumor grade and glioma outcome, Li et al. clarified the complicated crosstalk of Annexin A2 (ANXA2) with Glypican 1 (GPC1) and demonstrate whether combined indexes of ANXA2 and GPC1 could improve the prognostic evaluation for glioma patients. Li et al. found that ANXA2-induced glioma cell proliferation in a c-Myc-dependent manner. ANXA2 increased the expression of GPC1 via c-Myc and the upregulated GPC1 further promoted the c-Myc level, forming a positive feedback loop, which eventually led to enhanced proliferation of glioma cells. Both mRNA and protein levels of ANXA2 were upregulated in glioma tissues and coincided with the overexpression of GPC1. Besides, they utilized tissue microarrays (TMAs) and immunohistochemistry to demonstrate that glioma patients with both high expressions of ANXA2 and GPC1 tended to have a higher rate of tumor recurrence and shorter overall survival (OS). In conclusion, the overexpression of ANXA2 promotes proliferation of glioma cells by forming a GPC1/c-Myc positive feedback loop, and ANXA2 together with its downstream target GPC1 could be a potential “combination biomarker” for predicting the prognosis of glioma patients ¹⁾.

Glioma Quality of Life

see Glioma Quality of Life.

The ability to resume professional activities following brain tumor surgery is an important patient-oriented outcome parameter. Senft et al. found that the majority of patients with gliomas were able to return to work following surgical and adjuvant treatment. Preservation of neurological function is of utmost relevance for individual patients quality of life ²⁾

Patients with IDH and TERTp glioma mutations have the best prognosis, and only IDH mutation patients and only TERTp mutation patients have the worst prognosis. Moreover, the molecular classification of gliomas by mutations of IDH and TERTp is not suitable for pediatric patients ³⁾.

Also the O6 methylguanine DNA methyltransferase (MGMT) promoter methylation status seem to be the most important predictors of survival.

Infiltrative gliomas invade the brain, relentlessly recur, transform into higher-grade gliomas, and are invariably lethal ^4) 5) 6). , mostly due to the poor glioblastoma outcome (Grade IV glioma).

Gliomas are considered incurable due to recurrence as demonstrated in a series of five patients who underwent hemispherectomies in 1928 ⁷⁾.

The prognosis improves as the amount of glioma removed increases ^{8) 9) 10) 11) 12)}.

Older age (>40 years), high pathological grade, invasion of the corpus callosum and high levels of Ki67 expression were risk factors associated with the intracranial dissemination of gliomas ¹³⁾.

References