Atormac
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 2799  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed3094    
    Printed108    
    Emailed1    
    PDF Downloaded316    
    Comments [Add]    

Recommend this journal

 

 COMMITTEE REPORT
Year : 2009  |  Volume : 57  |  Issue : 3  |  Page : 247--251

A pragmatic clinicopathobiological grouping/staging system for gliomas: Proposal of the Indian TNM subcommittee on brain tumors


1 Department of Radiation Oncology, ACTREC/TMH, Mumbai, India
2 Department of Pathology, TMH, Tata Memorial Centre, Mumbai, India
3 Department of Pediatric Oncology, TMH, Tata Memorial Centre, Mumbai, India
4 Department of Neuro-Surgery, KEM Hospital, Mumbai, India

Correspondence Address:
Rajiv Sarin
Advanced Centre for Treatment Research and Education in Cancer Tata Memorial Centre, Kharghar, Navi Mumbai - 410210
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.53261

Rights and Permissions

Background: There is no universally accepted staging system for primary brain tumors wherein prognostication is mainly based on complex composite indices . Aim: To develop a simple, pragmatic, and widely applicable grouping/staging system for gliomas, the most common primary brain tumor. Materials and Methods: An expert neurooncology panel with representation from radiation oncology, neurosurgery, pathology, radiology, and medical oncology had several rounds of discussion on issues pertinent to brain tumor staging. The trade off was between the accuracy of prognostic categorization and a pragmatic, widely applicable approach. Results and Recommendations: The Tumor-Node-Metastasis staging was considered irrelevant for gliomas that seldom metastasize to lymphatics or outside the neuraxis. Instead, a 4-point staging/grouping system is proposed, using histological grade as the main prognostic variable and at least one stage migration based on other unfavorable features such as tumor location (brainstem); age (<5 years for all grades, >50 years for high-grade, and >40 years for low-grade gliomas); poor neurological performance status (NPS 2-4); multicentricity and/or gliomatosis; and adverse biological parameters (proliferative index, angiogenesis markers, apoptotic index, cytogenetic abnormalities, and molecular markers). Conclusion: In absence of a grouping/staging system for primary brain tumors, prognostification is mostly based on complex composite indices. The proposed clinicopathobiological grouping/staging system for gliomas is a simple, pragmatic, and user-friendly tool with a potential to fulfill the objectives of staging classification.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 20th March '04
Published by Wolters Kluwer - Medknow