Supratentorial World Health Organization Grade 2 astrocytomas and oligoastrocytomas : A new pattern of prognostic factors

✍ Scribed by Friedrich W. Kreth; Michael Faist; Reinhard Rossner; Benedikt Volk; Christoph B. Ostertag

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 248 KB
• Volume: 79
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19970115)79:2<370::aid-cncr21>3.0.co;2-x

✦ Synopsis

Background:

Prognostic factors for adult patients with supratentorial world health organization (who) grade 2 astrocytomas and poorly defined.

Methods:

The prognostic importance of pretreatment patient- and tumor-related factors was analyzed retrospectively in 197 adult patients with supratentorial astrocytomas (n = 153) or oligoastrocytomas (n = 44) using the multivariate cox proportional hazards model. endpoints were death and date of malignant transformation. all patients were treated similarly between 1979 and 1992 with iodine-125 implants as the primary treatment.

Results:

A new prognostic pattern was detected. unfavorable prognostic factors with regard to survival were 1) a tumor volume > or = 20 ml; 2) a performance status < or = 80; and 3) age > or = 40 years for the female subpopulation. midline shift (another important tumor-related factor after univariate analysis) was highly correlated with tumor volume and therefore not included in the multivariate model. risk factors of malignant transformation were 1) a tumor volume > or = 20 ml; 2) an enhancement in the computed tomography scan; and 3) age > or = 40 years for the female subpopulation. prognostic factors created subsets of patients with 5-year survival rates ranging from as low as 5% to as high as 79%.

Conclusions:

Any treatment decision or evaluation of treatment efficacy should take into account the strong influence of both patient- and tumor-related factors. any further study design should consider the detected interaction between gender and age and the importance of tumor volume.