Analysis of Prognostic and Survival Factors Related to Treatment of Low-Grade Astrocytomas in Adults
Prognostic factors for low-grade astrocytomas have been proposed, but optimal treatment remains controversial. Eighty-eight consecutive adult patients with supratentorial low-grade astrocytomas were retrospectively reviewed to determine specific factors influencing outcome. All underwent craniotomy...
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| Veröffentlicht in: | Oncology 2000-01, Vol.58 (2), p.108-116 |
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| creator | Nakamura, Mitsutoshi Konishi, Noboru Tsunoda, Shigeru Nakase, Hiroyuki Tsuzuki, Toshihide Aoki, Hideo Sakitani, Hiroyuki Inui, Takuo Sakaki, Toshisuke |
| description | Prognostic factors for low-grade astrocytomas have been proposed, but optimal treatment remains controversial. Eighty-eight consecutive adult patients with supratentorial low-grade astrocytomas were retrospectively reviewed to determine specific factors influencing outcome. All underwent craniotomy (43 radical resections, 45 nonradical resections). Sex, age at diagnosis, preoperative Karnofsky performance status (KPS), tumor location, estimated extent of resection, radiation, chemotherapy, histological type, p53 status, MIB-1 staining and the apoptotic index were assessed as parameters for prognostic significance. KPS (p = 0.03), tumor location (p < 0.001), extent of surgical resection (p < 0.001) and radiotherapy (p = 0.01) were significantly assoicated with longer survival rates by univariate analysis. Multivariate analysis also showed a significant correlation between radiation therapy after surgical removal and survival time (p < 0.001). p53 status was not of importance in determining the necessity for radiotherapy. Radical surgical removal is the most important factor in the management of low-grade astrocytomas. Radiation therapy appears to be effective in improving the prognosis regardless of the extent of surgical resection or the p53 status. |
| doi_str_mv | 10.1159/000012087 |
| format | Article |
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Eighty-eight consecutive adult patients with supratentorial low-grade astrocytomas were retrospectively reviewed to determine specific factors influencing outcome. All underwent craniotomy (43 radical resections, 45 nonradical resections). Sex, age at diagnosis, preoperative Karnofsky performance status (KPS), tumor location, estimated extent of resection, radiation, chemotherapy, histological type, p53 status, MIB-1 staining and the apoptotic index were assessed as parameters for prognostic significance. KPS (p = 0.03), tumor location (p < 0.001), extent of surgical resection (p < 0.001) and radiotherapy (p = 0.01) were significantly assoicated with longer survival rates by univariate analysis. Multivariate analysis also showed a significant correlation between radiation therapy after surgical removal and survival time (p < 0.001). p53 status was not of importance in determining the necessity for radiotherapy. Radical surgical removal is the most important factor in the management of low-grade astrocytomas. Radiation therapy appears to be effective in improving the prognosis regardless of the extent of surgical resection or the p53 status.</description><identifier>ISSN: 0030-2414</identifier><identifier>EISSN: 1423-0232</identifier><identifier>DOI: 10.1159/000012087</identifier><identifier>PMID: 10705237</identifier><language>eng</language><publisher>Basel, Switzerland: Karger</publisher><subject>Adult ; Age Factors ; Analysis of Variance ; Apoptosis ; Astrocytoma - chemistry ; Astrocytoma - drug therapy ; Astrocytoma - pathology ; Astrocytoma - radiotherapy ; Astrocytoma - surgery ; Astrocytoma - therapy ; Biological and medical sciences ; Brain Neoplasms - chemistry ; Brain Neoplasms - drug therapy ; Brain Neoplasms - pathology ; Brain Neoplasms - radiotherapy ; Brain Neoplasms - surgery ; Brain Neoplasms - therapy ; Female ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Karnofsky Performance Status ; Laboratory/Clinical Translational Research ; Male ; Medical sciences ; Middle Aged ; Mutation ; Neurology ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Risk Factors ; Sex Factors ; Survival Analysis ; Tumor Suppressor Protein p53 - genetics ; Tumors of the nervous system. 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Eighty-eight consecutive adult patients with supratentorial low-grade astrocytomas were retrospectively reviewed to determine specific factors influencing outcome. All underwent craniotomy (43 radical resections, 45 nonradical resections). Sex, age at diagnosis, preoperative Karnofsky performance status (KPS), tumor location, estimated extent of resection, radiation, chemotherapy, histological type, p53 status, MIB-1 staining and the apoptotic index were assessed as parameters for prognostic significance. KPS (p = 0.03), tumor location (p < 0.001), extent of surgical resection (p < 0.001) and radiotherapy (p = 0.01) were significantly assoicated with longer survival rates by univariate analysis. Multivariate analysis also showed a significant correlation between radiation therapy after surgical removal and survival time (p < 0.001). p53 status was not of importance in determining the necessity for radiotherapy. Radical surgical removal is the most important factor in the management of low-grade astrocytomas. Radiation therapy appears to be effective in improving the prognosis regardless of the extent of surgical resection or the p53 status.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Analysis of Variance</subject><subject>Apoptosis</subject><subject>Astrocytoma - chemistry</subject><subject>Astrocytoma - drug therapy</subject><subject>Astrocytoma - pathology</subject><subject>Astrocytoma - radiotherapy</subject><subject>Astrocytoma - surgery</subject><subject>Astrocytoma - therapy</subject><subject>Biological and medical sciences</subject><subject>Brain Neoplasms - chemistry</subject><subject>Brain Neoplasms - drug therapy</subject><subject>Brain Neoplasms - pathology</subject><subject>Brain Neoplasms - radiotherapy</subject><subject>Brain Neoplasms - surgery</subject><subject>Brain Neoplasms - therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>In Situ Nick-End Labeling</subject><subject>Karnofsky Performance Status</subject><subject>Laboratory/Clinical Translational Research</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Neurology</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Survival Analysis</subject><subject>Tumor Suppressor Protein p53 - genetics</subject><subject>Tumors of the nervous system. 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Eighty-eight consecutive adult patients with supratentorial low-grade astrocytomas were retrospectively reviewed to determine specific factors influencing outcome. All underwent craniotomy (43 radical resections, 45 nonradical resections). Sex, age at diagnosis, preoperative Karnofsky performance status (KPS), tumor location, estimated extent of resection, radiation, chemotherapy, histological type, p53 status, MIB-1 staining and the apoptotic index were assessed as parameters for prognostic significance. KPS (p = 0.03), tumor location (p < 0.001), extent of surgical resection (p < 0.001) and radiotherapy (p = 0.01) were significantly assoicated with longer survival rates by univariate analysis. Multivariate analysis also showed a significant correlation between radiation therapy after surgical removal and survival time (p < 0.001). p53 status was not of importance in determining the necessity for radiotherapy. Radical surgical removal is the most important factor in the management of low-grade astrocytomas. Radiation therapy appears to be effective in improving the prognosis regardless of the extent of surgical resection or the p53 status.</abstract><cop>Basel, Switzerland</cop><pub>Karger</pub><pmid>10705237</pmid><doi>10.1159/000012087</doi><tpages>9</tpages></addata></record> |
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| source | Karger Journals; MEDLINE |
| subjects | Adult Age Factors Analysis of Variance Apoptosis Astrocytoma - chemistry Astrocytoma - drug therapy Astrocytoma - pathology Astrocytoma - radiotherapy Astrocytoma - surgery Astrocytoma - therapy Biological and medical sciences Brain Neoplasms - chemistry Brain Neoplasms - drug therapy Brain Neoplasms - pathology Brain Neoplasms - radiotherapy Brain Neoplasms - surgery Brain Neoplasms - therapy Female Humans Immunohistochemistry In Situ Nick-End Labeling Karnofsky Performance Status Laboratory/Clinical Translational Research Male Medical sciences Middle Aged Mutation Neurology Predictive Value of Tests Prognosis Retrospective Studies Risk Factors Sex Factors Survival Analysis Tumor Suppressor Protein p53 - genetics Tumors of the nervous system. Phacomatoses |
| title | Analysis of Prognostic and Survival Factors Related to Treatment of Low-Grade Astrocytomas in Adults |
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