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Abstract
Introduction. Over time, all low-grade gliomas (LGG) (grade 2) inevitably undergo malignant transformation (MT) to grade 3 or grade 4.
Aim. To review the published literature on factors influencing malignant transformation in patients with grade 2 astrocytoma harboring IDH1/2 mutations and grade 2 oligodendroglioma (ODG) harboring IDH1/2 mutations and 1p/19q codeletion.
Materials and Methods. A literature review was conducted to identify factors affecting the rate of recurrence and anaplastic transformation in patients with LGG. Clinical, radiological, and biological criteria were examined, along with the role of surgical resection, morphogenetic characteristics, and adjuvant therapy.
Results. Thirty-two different parameters were identified that significantly influence the occurrence of relapse and the incidence of MT. Some of them (n = 8) slow this process, contributing to a longer relapse-free period and a lower risk of anaplastic transformation (p < 0.05). These factors include: epileptic seizures, Karnofsky Performance Status > 90 %, circumscribed tumor growth pattern, gross total (near-total) resection, presence of 1p/19q codeletion (ODG), and adjuvant therapy (radiotherapy and chemotherapy).
Conclusion. Malignant transformation with relapse in patients with grade 2 astrocytoma and grade 2 ODG is an inevitable process. Factors that have a greater impact on the occurrence of relapse and the frequency of MT have been identified.
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