Anaplastic astrocytomas: survival and prognostic factors in a surgical series

• Published in: Acta neurochirurgica Vol. 156; no. 6; pp. 1053 - 1061
• Main Authors: Rogne, Siril G., Konglund, Ane, Scheie, David, Helseth, Eirik, Meling, Torstein R.
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.06.2014; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Astrocytoma - mortality; Astrocytoma - surgery; Clinical Article - Brain Tumors; Female; Humans; Interventional Radiology; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Neurology; Neuroradiology; Neurosurgery; Norway - epidemiology; Prognosis; Surgical Orthopedics; Young Adult; Overall survival; Surgery; Anaplastic astrocytoma; Prognostic factors; High grade glioma
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-014-2053-5

Background To study patient characteristics, prognostic factors and overall survival (OS) in a consecutive, surgical series of WHO grade III anaplastic astrocytomas (AA). Methods Patients were identified from a prospective tumor database at Oslo University Hospital, Norway, and patients undergoing surgery for an AA from 2005–2012 were included. Patients’ medical charts were retrospectively reviewed for data collection. Results A total of 99 adult patients with histologically verified AA were included. Median age was 52 years (20–81). Biopsy was conducted in 33 % and resection in 67 %. Adjuvant treatment with radiation therapy + temozolomide or radiation therapy only was given in 63 % and 26 %, respectively. The thirty-day mortality rate was 3 %. Median OS was 19 months (95 % CI 11–27 months). Age ≥ 65 years, KPS < 70, biopsy as opposed to resection, and no adjuvant treatment were confirmed negative prognostic factors in multivariate analysis. For patients undergoing resection, presence of postoperative contrast-enhanced tumor, not volume of residual tumor, had significant impact on OS in adjusted analysis. Conclusions Median OS following surgery was 19 months, though much variable outcome was observed among subgroups of AA (95 % CI 11–27 months). Age ≥65 years, KPS < 70, biopsy as opposed to resection, and no adjuvant treatment were confirmed negative prognostic factors for OS.