eMedicine Specialties > Neurology > Neuro-oncology

Oligodendroglioma: Follow-up

Author: ABM Salah Uddin, MD, Consulting Staff, Department of Internal Medicine, St Vincent's Hospital
Coauthor(s): Tambi Jarmi, MD, Resident Physician, Department of Internal Medicine, Carraway Methodist Medical Center
Contributor Information and Disclosures

Updated: May 4, 2009

Follow-up

Further Inpatient Care

After the initial surgical resection and rehabilitation, the patient may require further inpatient care depending on the development of complications from either therapy or tumor recurrence. Appropriate intervention also depends on the nature of complications (eg, surgery for recurrence, steroid therapy for increased vasogenic edema).

Further Outpatient Care

After initial appropriate management, closely monitor the patient with the family for tumor recurrence or chemotherapy-induced adverse effects. Monitor with regular follow-up care and MRI scans every 3 months initially and then every 6 months to 1 year.

Inpatient & Outpatient Medications

Patients with seizures require appropriate seizure medications even after surgery. Over time, the dose of the medications can be reduced, depending on the frequency of seizures.

Transfer

Transfer depends on the residual neurological deficit. The patient may be fully ambulatory or may need appropriate transfer arrangements (eg, cane, wheelchair).

Complications

Closely observe the patient for any complications resulting from continuing treatment, such as radiation necrosis from radiation therapy or neuropathy from chemotherapy.

Prognosis

  • Combined loss of 1p/19q is a significant predictor of overall survival in anaplastic oligodendroglioma and is also significantly associated with longer recurrence-free survival and chemosensitivity.
  • The phosphatase and tensin homologue deleted by chromosome 10 (PTEN) alteration is associated with a poor prognosis.
  • Other variables, including age of the patient at time of diagnosis, location and extent of surgical resection, postoperative performance status, histologic features of the tumor, and use of adjuvant therapies and early presentation with seizures, determine the prognosis for an individual patient. Overall, as many as three fourths of patients with nonanaplastic tumors can be expected to survive 5 years from the time of diagnosis, with a median reported survival duration of 6-10 years. For those with anaplastic oligodendrogliomas, median survival is more likely to be 3-4 years. Late progression of disease is common, so the usual 5-year survival time used to indicate "cure" in other cancers is not relevant for oligodendrogliomas.

Patient Education

Throughout the entire process, educate the patient and family through regular follow-up care and involvement of support groups to cope with physical, emotional, and spiritual stress. With proper education, the patient and family can develop good insight into the course and prognosis of the tumor.

Miscellaneous

Medicolegal Pitfalls

  • Intraventricular oligodendrogliomas must be differentiated from the histologically very similar appearing central neurocytoma and dysembryoplastic neuroepithelial tumor. These tumors have a better prognosis. By considering and recognizing these tumors, inappropriate treatment by chemotherapy and radiotherapy and their medicolegal consequences can be avoided.12
  • As oligodendrogliomas commonly present with a long history of seizure, every patient with a history of intractable seizure and middle-aged patients with new onset of seizure should be evaluated aggressively by MRI scans. This will avoid unnecessary delay in diagnosis and ensure appropriate treatment for better quality of life and prolonged survival.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Subramanian Hariharan, MD to the development and writing of this article.



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Differential Diagnoses & Workup: Oligodendroglioma
Treatment & Medication: Oligodendroglioma
Follow-up: Oligodendroglioma
Multimedia: Oligodendroglioma
References
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Further Reading

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Keywords

oligodendroglioma, OD, LGO, anaplastic oligodendroglioma, glial brain tumor, intracranial tumors, low-grade oligodendrogliomas

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Contributor Information and Disclosures

Author

ABM Salah Uddin, MD, Consulting Staff, Department of Internal Medicine, St Vincent's Hospital
ABM Salah Uddin, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Tambi Jarmi, MD, Resident Physician, Department of Internal Medicine, Carraway Methodist Medical Center
Tambi Jarmi, MD is a member of the following medical societies: American College of Physicians and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Amy A Pruitt, MD, Associate Professor of Neurology, University of Pennsylvania; Attending Neurologist, Hospital of the University of Pennsylvania
Amy A Pruitt, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jorge Kattah, MD, Head, Program Director, Professor, Department of Neurology, University of Illinois College of Medicine at Peoria
Jorge Kattah, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, and New York Academy of Sciences
Disclosure: Biogen Honoraria Consulting; Bayer Corporation Honoraria Consulting

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Stephen A Berman, MD, PhD, Professor, Department of Internal Medicine, Section of Neurology, Dartmouth Medical School; Chief, Neurology Service, White River Junction Veterans Medical Center
Stephen A Berman, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

 
 
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