How is glioma graded?

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 02, 2024
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According to the characteristics of pathology, gliomas are divided into grades one to four. Grade one is a low-grade malignancy, more benign tumor, accounting for about 5%, with a relatively high probability of successful surgical outcomes. Grade two accounts for about 35%, and after comprehensive treatment including surgery, the survival rate can reach five to ten years, or even longer. Grade three usually develops from grade two, with relatively poor prognosis, and the average survival period is about two years. Grade four, the most malignant glioma, also known as glioblastoma, accounts for about 30%-40%, with an average survival period of less than one year, and very poor outcomes.

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Written by Chen Yu Fei
Neurosurgery
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Is glioma malignant?

Glioblastoma is a type of malignant tumor, which generally grows at a fast pace. In the early stages of the disease, the glioma often adheres to the surrounding tissues, posing significant challenges for future complete surgical removal. At the same time, extensive cerebral edema occurs around the glioma. If prolonged, this can lead to a serious increase in intracranial pressure, manifesting as repeated headaches, dizziness, nausea, and vomiting in the patient. Over time, this condition may also lead to optic nerve atrophy, resulting in decreased vision and visual field defects. Diagnosis generally benefits from cranial CT or MRI scans, but definitive diagnosis still requires surgical removal of the tumor. A small amount of tumor tissue is typically retained for pathological biopsy.

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Written by Chen Yu Fei
Neurosurgery
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Principles of Treatment for Glioma

For patients with glioma, the primary treatment method is still to surgically remove the tumor, followed by postoperative radiotherapy, chemotherapy, and other related treatments. The main treatment principle is to detect, diagnose, and treat early. During surgery, the tumor should be removed as completely as possible, and it is advisable to receive postoperative radiotherapy and chemotherapy early to effectively consolidate the surgical treatment effects. This helps to kill tumor cells to the greatest extent, slow down the probability and timing of tumor recurrence, and extend the patient's lifespan as much as possible. Therefore, for patients with glioma, it is recommended to choose to seek surgical treatment at well-known, top-tier hospitals locally.

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Written by Chen Yu Fei
Neurosurgery
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Clinical manifestations of glioma

For patients with glioma, as it is a malignant tumor with a rapid growth rate, they may exhibit severe symptoms at the early stage of the disease, including severe headaches, dizziness, nausea, vomiting, loss of appetite, poor mental state, poor sleep quality at night, frequent insomnia and nightmares, and easy waking up. As the tumor increases in size, it often causes an increase in intracranial pressure. In severe cases, this may lead to optic disc edema, decreased vision, and visual field defects. Additionally, some patients may experience impairment in motor functions, manifesting as hemiplegia, and in some cases, aphasia. It is advised to undergo surgery in the early stages, followed by radiotherapy and chemotherapy.

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Written by Gao Yi Shen
Neurosurgery
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Glioma Symptoms

The symptoms of glioma are numerous, and it is essential to make judgments based on the situation. The most common clinical manifestations are headaches, dizziness, nausea, and vomiting. These symptoms may persist for a relatively long period and are relatively mild, not immediately noticeable at the time. Additionally, some patients may experience a decline in cognitive function, colloquially described as becoming less intelligent. This is especially common in gliomas of the frontal lobe. If the glioma is located in the occipital lobe, it often causes visual disturbances, such as blurred vision and visual field defects. In cases of temporal lobe gliomas, frequent seizures and impaired limb mobility may occur. For cerebellar gliomas, symptoms can include a decline in cognitive function and ataxia, among others.

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Written by Gao Yi Shen
Neurosurgery
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Is a glioma benign or malignant?

Glioblastoma is the most common form of malignant tumor inside the skull, and the vast majority of glioblastomas are highly malignant. Once changes in this condition are detected, generally, the patient doesn't have much time left. If it is a relatively better glioblastoma, which means it is highly differentiated, the survival time is about 1-2 years. For some poorer glioblastomas, or those with low differentiation, their survival period is often only about six months, and they continuously spread along with nerve fibers to the surrounding areas. They might even metastasize to distant places through cerebrospinal fluid, blood, lymph, and other means. Therefore, even if surgery is used to remove a single lesion, other parts of the body may still demonstrate metastatic lesions. Hence, the treatment approach for this is comprehensive.