S-Space College of Medicine/School of Medicine (의과대학/대학원) Neurosurgery (신경외과학전공) Journal Papers (저널논문_신경외과학전공)
Revisiting anaplastic astrocytomas I: an expansive growth pattern is associated with a better prognosis
- Moulding, Hugh D; Friedman, David P; Curtis, Mark; Kenyon, Lawrence; Flanders, Adam E; Paek, Sun Ha; Andrews, David W
- Issue Date
- J Magn Reson Imaging. 2008;28(6):1311-1321
- Adult; Astrocytoma/*pathology/surgery; Brain Neoplasms/*pathology/surgery; Chi-Square Distribution; Contrast Media; Craniotomy; Female; Gadolinium DTPA/diagnostic use; Humans; Magnetic Resonance Imaging/*methods; Male; Middle Aged; Neoplasm Staging; Prognosis; Proportional Hazards Models; Retrospective Studies; Statistics, Nonparametric; Survival Analysis; Treatment Outcome
- PURPOSE: To study whether anaplastic astrocytomas that are nonenhancing and/or well-circumscribed (expansive) are associated with a better prognosis. MATERIALS AND METHODS: We retrospectively identified 59 patients with pathologically confirmed World Health Organizaiton (WHO) grade III anaplastic astrocytoma who underwent craniotomy at our institution from 1995 through 2006. We assessed prognostic variables including age, enhancement (EAA-34 patients) vs. nonenhancement (NEAA-25 patients), MR growth patterns (expansive [28 patients] vs. mixed/infiltrative [31 patients]), recursive partitioning analysis (RPA) class, resection extent, and addition of chemotherapy. Primary outcome measure was survival. RESULTS: Kaplan-Meier curves showed improved survival in NEAA, expansive tumors, and RPA 1 class patients. Within RPA class I patients, expansive growth pattern remained a significant advantage in survival time. Examining extent of resection also showed that patients with gross total resections (GTR) had a better prognosis. A multivariate (Cox proportional hazards) analysis showed that patient age and expansive tumor phenotype affected outcome, whereas RPA class, enhancement, and GTR did not. CONCLUSION: Circumscribed growth in histologically proven anaplastic astrocytoma, which has not been emphasized in past studies, has a considerable survival advantage.
- 1053-1807 (Print)
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