AUTHOR=Kivioja Tomi , Posti Jussi P. , Sipilä Jussi , Rauhala Minna , Frantzén Janek , Gardberg Maria , Rahi Melissa , Rautajoki Kirsi , Nykter Matti , Vuorinen Ville , Nordfors Kristiina , Haapasalo Hannu , Haapasalo Joonas 

TITLE=Motor dysfunction as a primary symptom predicts poor outcome: multicenter study of glioma symptoms

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1305725

DOI=10.3389/fonc.2023.1305725

ISSN=2234-943X

ABSTRACT=Background and Objectives The objectives of this study were to investigate the prognostic value of primary symptoms and leading symptoms in adult patients with diffuse infiltrating glioma and to provide a clinical perspective for evaluating survival.
Methods This study included a retrospective cohort from two tertiary university hospitals (n = 604, 2006–2013, Tampere University Hospital and Turku University Hospital) and a prospective cohort (n = 156, 2014–2018, Tampere University Hospital). Preoperative symptoms were divided into primary and leading symptoms. Results were validated with the newer WHO 2021 classification criteria.
Results The most common primary symptoms were epileptic seizure (30.8% retrospective, 28.2% prospective), cognitive disorder (13.2% retrospective, 16.0% prospective), headache (8.6% retrospective, 12.8% prospective), and motor paresis (7.0% retrospective, 7.1% prospective). Symptoms that predicted better survival were epileptic seizure and visual or other sense-affecting symptom in the retrospective cohort and epileptic seizure and headache in the prospective cohort. Predictors of poor survival were cognitive disorder, motor dysfunction, sensory symptom, tumor haemorrhage, speech disorder and dizziness in the retrospective cohort and cognitive disorder, motor dysfunction, sensory symptom, and dizziness in the prospective cohort. Motor dysfunction served as an independent predictor of survival in a multivariate model (OR = 1.636).
Conclusion Primary and leading symptoms in diffuse gliomas are associated with prognoses in retrospective and prospective settings. Motor paresis was an independent prognostic factor for poor survival in multivariate analysis for grade 2-4 diffuse gliomas, especially in updated WHO 2021 glioblastoma.