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How long could the patient with canglioma survive after diagnosis?

How long could the patient with canglioma survive after diagnosis? Glioma is the most common primary malignant brain tumor in adults. They can occur anywhere in the central nervous system, but mainly occur in the brain and glial tissue.

Although these tumors are usually malignant, some types of tumors do not always manifest in a malignant manner. Glioma can be astrocyte type, oligodendrocyte type, or a mixed type of these two cell types, usually according to the International Classification of Diseases-Oncology 3rd Edition (ICD-O-3) and World Health Organization (WHO) classification for classification.

According to the pathological nature, gliomas can be WHO grade I-IV. The most common histological types of adult glioma include astrocytoma (grade I-IV), oligodendroglioma (grade II-III), and oligodendroglioma (grade II-III).

However, there is no consistent definition of glioma as a larger histological category, which makes comparisons between studies challenging. This review mainly includes recent (2002-2013) studies on certain risk factors in the epidemiology of adult (age ≥ 20 years) glioma, excluding extremely rare ependymomas.

How long can glioma live after diagnosis?

The most decisive prognostic factors for glioblastoma are the degree of tumor resection, age at diagnosis, and Karnofsky performance status. The survival rates of all glioma subtypes also vary significantly by grade.

Many research teams that track the incidence of glioma also track the proportion of people who survive a period of time after diagnosis. Table 2 lists the 5-year relative survival rates of glioma histology based on population studies (see Supplementary Table 2 for the 1-year and 10-year relative survival rates).

Pilocytic astrocytoma (grade I) has the highest relative survival rate. Glioblastoma has the lowest overall survival rate, with only 0.05% to 4.7% of patients surviving 5 years after diagnosis.

In general, gliomas with oligodendrocyte components have a higher survival rate than gliomas with astrocytic components. The age of 18-20 is significantly related to the survival rate of all gliomas after diagnosis, but the impact on glioblastoma is the most obvious.

Recently, a population-based parallel cohort study of diffuse low-grade glioma showed that early surgical resection has a better overall survival rate than biopsy and watchful waiting.

The 22981/26981 trial conducted by the European Organization for Research and Treatment of Cancer/National Cancer Institute of Canada proved that the survival rate of glioblastoma patients who received temozolomide and postoperative radiotherapy at the same time improved, and the median survival of patients who received treatment at the same time The period was 14.6 months, and the median survival time of patients who received radiotherapy alone was 12.1 months.

This treatment plan, commonly known as the Stupp plan, is the result of this trial and was first proposed in 2004.

In the years since the completion of this trial, it has been established as the standard of treatment for primary glioblastoma.

Due to various reasons, including tolerance to chemotherapy, access to chemotherapy drugs, and overall performance status, not all patients with glioblastoma receive this regimen.

This result was subsequently confirmed in a large study of patients with glioblastoma. Multiple analyses found that after the occurrence of glioblastoma, especially in patients who received radiation therapy after surgery, they survived The rate has a statistically significant upward trend.

The survival rate of oligodendroglioma has an upward trend, which is also attributed to the improvement of diagnosis and treatment.

Why can’t glioma be cured?

When symptoms of glioma appear, the biological process is almost always too late. Moving solitary tumor/stem cells will migrate beyond the tumor mass defined by imaging.

These will eventually start another tumor at the edge of the resection, a certain distance from the edge, or even in the contralateral hemisphere. Moreover, this is purely a function of time, with or without the benefits of surgery.

Radiation therapy and chemotherapy may have some effects on some of these cells, but there will always be individual cells, or even a small number of cells, that will not be affected by these methods-just like normal brain cells that we hope will not be affected by treatment .

The real culprit is not necessarily “cancer” cells. The real culprit is stem cells, which are similar to “normal” cells. When gliomas are diagnosed, when symptoms appear and imaging studies are performed, most of them are incurable.

Some neurosurgeons may think of one or two cases, whose MRI showed obvious glioblastoma, but they also happened to have an early MRI examination for other reasons, such as headache or minor trauma. The early MRI was completely normal. There have been such cases.

In these cases, the transition from low-grade mixed glioma to malignant astrocytoma occurs much faster than most cases, and may last for weeks or months. I think such cases are relatively rare. In fact, I have seen more cases. Doctors have observed that the MRI T2 abnormality is getting bigger and bigger in a few years, but they feel that they must wait until the symptoms appear before recommending surgery.

In the past 30 years, we have seen real progress in the development of cutting-edge surgical technology. Computer-based medical imaging combined with stereotactic navigation technology for minimally invasive surgery or non-invasive radiosurgery methods, intraoperative imaging, mapping procedures, etc., make tumor neurosurgery minimally invasive, effective and safe. However, we are fighting a war in the removal of gliomas, and we need a screening program for early detection of gliomas

(source:internet, reference only)

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