# Prognostic impact of tumor size on cancer-specific survival for postoperative WHO grade II oligodendroglioma: a SEER-based study

## TL;DR

This study finds that tumor size is a key factor in predicting survival outcomes for patients with grade II oligodendroglioma after surgery.

## Contribution

The study identifies tumor size as an independent prognostic factor and establishes a 60 mm cut-off for risk stratification in postoperative OG/II patients.

## Key findings

- Tumor size of 60 mm is an optimal cut-off for predicting cancer-specific survival in OG/II patients.
- Age > 60, male sex, and incomplete resection are associated with worse survival outcomes.
- A tumor size-based nomogram was developed to guide treatment decisions for OG/II patients.

## Abstract

WHO grade II oligodendroglioma (OG/II) is a rare primary brain tumor with various outcomes. Our study aims to investigate prognostic factors for postoperative OG/II patients and then evaluate the instructional value of tumor size.

We retrospectively studied the cases from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox analyses and Kaplan-Meier survival curves were used to identify and assess prognostic factors. The optimal cut-off value of tumor size was determined by X-tile analysis and verified by multivariate analyses. Subsequently, Subgroup analyses were performed based on tumor size.

676 OG/II patients were enrolled in our study. Multivariate Cox analyses revealed that age > 60 (HR 3.52), male (HR 1.48), total resection (HR 0.38), and tumor size (HR 2.04) were independent factors in predicting cancer-specific survival (CCS). The optimal cut-off value for tumor size was 60 mm. Patients with tumor size less than 60 mm, age > 60 (HR 3.82), and radiation (HR 1.58) were associated with worse CSS, while total resection (HR 0.35) was associated with better CSS. Lastly, a tumor size-based nomogram was established objectively and accurately.

Our study identified four crucial prognostic factors related to CSS in postoperative OG/II patients: age, sex, the extent of recession, and tumor size. A tumor size of 60 mm was an optimal cut-off point for dividing patients into low and high-risk groups. Patients in the low-risk group may not benefit from extended resection and radiation. Tumor size can be a valuable factor for making therapeutic schedules.