Supratentorial recurrences of gliomas

Summary

We report a tissue culture study of 50 recurrent supratentorial gliomas. From the initial and recurrent operations 23 astrocytomas and 8 oligodendrogliomas were cultured. 15 astrocytomas and 4 oligodendrogliomas were explanted at the time of recurrence only. On the basis of a three-stage grading system 6 astrocytomas were originally classified as A 1, and 17 as A 2 on cultivation. Oligodendrogliomas proved originally to be O 1 in three cases, and O 2 in five cases. After reoperations all of the A 1 astrocytomas became A 2, 16 A 2 astrocytomas remained unchanged, one A 2 astrocytoma changed, to a glioblastoma. After the third operation one A 2 astrocytoma retained its character, and another one transformed to a glioblastoma. All recurrences of O 1 oligodendrogliomas changed to O 2, and one of them retained this character after the third and fourth operations as well. In the O 2 group, two recurrent oligodendroglioma were unchanged, and three became glioblastomas. The second recurrence of a single O 2 oligodendroglioma showed transformation to a glioblastoma. Cultures indicated a high tendency toward malignant changes, both in astrocytomas and oligodendrogliomas. These changes were closely connected with the presence of immature glial cells. By comparing the tissue culture findings with the clinical data, we conclude that on the basis of cytological malignancy an exact prediction of clinical recurrence is not possible.