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Early prognosis of supratentorial grade 2 astrocytomas in adult patients after resection or stereotactic biopsy

An analysis of 50 cases operated on between 1984 and 1988

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Summary

50 adult supratentorial low-grade astrocytomas operated upon between 1984 and 1988 were analysed retrospectively with respect to postoperative condition and progression-free survival. Pilocytic lesions were excluded. In 32 instances the tumour was macroscopically completely removed and partially in 4. In 14 cases a stereotactic biopsy was performed only. 10 patients received postoperative radiotherapy with 55 to 65 Gy. 1 patient died perioperatively from pulmonary embolism. 39 patients could resume their previous activities after discharge from the hospital, 10 were significantly disabled by neurological deficit, reduced neuropsychological performance or medically intractable epilepsy. Postoperatively, most patients required continuous anti-epileptic medication. 10 recurrences or tumour progressions of incompletely removed or merely biopsied lesions were observed within the mean follow-up period of 22 months. All recurrences after gross total removal, that were reoperated, had progressed to a malignant glioma. Of the prognostic tumour characteristics analysed, a histologically well-delineated tumour demarcation was most clearly associated with a favourable prognosis. Concerning treatment modalities, gross total resection was associated with a favourable prognosis. Radiotherapy was associated with an unfavourable outcome but this is probably due to selection of otherwise unfavourable cases.

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References

  1. Afra D, Mueller W, Benoist G (1987) Supratentorial recurrence of gliomas. Results of reoperation on astrocytomas and oligodendrogliomas. Acta Neurochir (Wien) 43: 217–227

    Google Scholar 

  2. Bailey P, Cushing HA (1926) A classification of the tumours of the glioma group on a histogenetic basis with a correlated study of prognosis. Lippincott, Philadelphia.

    Google Scholar 

  3. Batzdorf V, Gold V (1974) Dispersion of central nervous system tumours. Correlation between clinical aspects and tissue culture studies. J Neurosurg 41: 691–698

    PubMed  Google Scholar 

  4. Berger MS, Kincaid J, Ojemann GA, Lettich E (1989) Brain mapping techniques to maximize resection, safety, and seizure control in children with brain tumors. Neurosurgery 25: 786–792

    PubMed  Google Scholar 

  5. Bookwalter III WJ, Selker RG, Schiffer L,et al (1984) Brain tumour cell kinetics correlated with survival. J Neurosurg 65: 795–798

    Google Scholar 

  6. Burger PC (1985) Gliomas: pathology. In: Wilkins RH, Rengachary SS (eds) Neurosurgery, vol 1. McGraw-Hill, New York, pp 553–563

    Google Scholar 

  7. Butler AR, Horli SC, Kricheff II (1978) Computed tomography in astrocytomas. A statistical analysis of the parameters of malignancy and the positive enhanced CT scan. Radiology 129: 433–439

    PubMed  Google Scholar 

  8. Coffey RJ, Lunsford LD, Taylor FH (1988) Survival after stereotactic biopsy of malignant gliomas. Neurosurgery 22: 465–473

    PubMed  Google Scholar 

  9. Cohadon F (1990) Indications for surgery in the management of gliomas. Adv Techn Standards in Neurosurg 17: 190–234

    Google Scholar 

  10. Cox DR (1972) Regression models and life-tables. J R Stat Soc 34: 187–220

    Google Scholar 

  11. Daumas-Duport C, Scheithauer BW (1987) A histologic and cytologic method for the spatial definition of gliomas. Mayo Clin Proc 62: 435–449

    PubMed  Google Scholar 

  12. Daumas-Duport C, Scheithauer B, O'Fallon J, Kelly P (1988) Grading of astrocytomas. A simple and reproducible method. Cancer 62: 2152–2165

    PubMed  Google Scholar 

  13. Fazekas JT (1977) Radiation oncology. Treatment of grade I and II lesion astrocytomas. The role of radiotherapy. Radiation Oncol Biol Phys 2: 661–662

    Google Scholar 

  14. Garcia DM, Fulling KH. Marks JE (1985) The value of radiation therapy in addition to surgery in astrocytomas of the adult cerebrum. Cancer 55: 919–927

    PubMed  Google Scholar 

  15. Hoshino T (1984) A commentary on the biology and growth kinetics of low grade and high grade gliomas. J Neurosurg 61: 895–900

    PubMed  Google Scholar 

  16. Hoshino T, Parker M, Wilson CB, Boldrey E, Fewer D (1972) Cell kinetics of human gliomas. J Neurosurg 37: 15–26

    PubMed  Google Scholar 

  17. Hoshino T, Rodriguez LA, Cho KG, Lee KS, Wilson CB, Edwards MS, Levin VA, Davis RL (1988) Prognostic implications of the proliferative potential of low-grade astrocytomas. J Neurosurg 69: 839–842

    PubMed  Google Scholar 

  18. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Ass 53: 457–481

    Google Scholar 

  19. Katakura T, Yoshimoto F (1988) Epidemiology and statistical analysis of gliomas. In: Suzuki J (ed) Treatment of glioma. Springer, Berlin Heidelberg New York Tokyo, pp 3–16

    Google Scholar 

  20. Kelly PJ, Daumas-Duport C, Scheithauer B, Kall BA, Kispert DB (1987) Stereotactic histologic correlations of computed tomography- and magnetic resonance imaging-defined abnormalities in patients with glial neoplasms. Mayo Clin Proc 62: 450–459

    PubMed  Google Scholar 

  21. Kelly P (1989) Stereotactic imaging, surgical planning and computer-assisted resection of intracranial lesions: methods and results. Adv Techn Standards in Neurosurg 17: 77–118

    Google Scholar 

  22. Kitahara M (1988) Clinical analysis of glioma: low grade astrocytoma. In: Suzuki J (ed) Treatment of glioma. Springer, Berlin Heidelberg New York Tokyo, pp 173–186

    Google Scholar 

  23. Lagarde P (1987) La radiothérapie des astrocytomes sustentoriels de bas grade. Thèse de Médecine, Bourdeaux, no 202

  24. Laws ER, William FT, Marvin BC, Okazaki H (1984) Neurosurgical management of low-grade astrocytoma of the cerebral hemisphere. J Neurosurg 61: 665–673

    PubMed  Google Scholar 

  25. Laws ER, Taylor WF, Bergstralh EJ, Okazaki H, Clifton MB (1986) The neurosurgical management of low-grade astrocytoma. Clin Neurosurg 33: 575–588

    PubMed  Google Scholar 

  26. Medberry CA, Straus KL, Steinberg SM, Cotelingam JD, Fisher WS (1988) Low-grade astrocytomas: treatment results and prognostic variables. Int J Radiat Oncol Biol Phys 15: 837–841

    PubMed  Google Scholar 

  27. Morantz RA (1987) Radiation therapy in the treatment of cerebral astrocytoma. Neurosurgery 20: 975–982

    PubMed  Google Scholar 

  28. Palma L, Guidetti B (1985) Cystic pilocytic astrocytomas of the cerebral hemispheres. J Neurosurg 62: 811–815

    PubMed  Google Scholar 

  29. Piepmeyer JM (1987) Observations on the current treatment of low-grade astrocytic tumours of the cerebral hemispheres. J Neurosurg 67: 177–181

    PubMed  Google Scholar 

  30. Scanlon PW, Taylor WF (1979) Radiotherapy of intracranial astrocytomas. Analysis of 417 cases treated from 1960 through 1969. Neurosurg 5: 301–308

    Google Scholar 

  31. Scott GM, Gilbert FB (1980) Epilepsy and other factors in the prognosis of gliomas. Acta Neurol Scand 61: 227–239

    PubMed  Google Scholar 

  32. Shaw EG, Daumas-Duport C, Scheithauer BW, Gilbertson DT, O'Fallon JR, Earle JD, Laws ER, Okazaki H (1989) Radiation therapy in the management of low-grade supratentorial astrocytomas. J Neurosurg 70: 853–861

    PubMed  Google Scholar 

  33. Soffietti R, Chio A, Giordana MT, Vasaro E, Schiffer D (1989) Prognostic factors in well-differentiated cerebral astrocytomas in the adult. Neurosurg 24: 686–692

    Google Scholar 

  34. Weir B (1973) The relative significance of factors affecting postoperative survival in astrocytomas grade 3 and 4. J Neurosurg 38: 448–452

    PubMed  Google Scholar 

  35. Weir B, Grace M (1976) The relative significance of factors affecting postoperative survival in astrocytomas grades one and two. Can J Neurol Sci 3: 47–50

    PubMed  Google Scholar 

  36. Wüllenweber R, Kuhlendahl H, Miltz H (1973) Astrocytomas of the cerebral hemispheres. In: Kuhlendahl H, Hensell V (eds) Modern aspects of neurosurgery, vol 3. Excerpta Medica, Amsterdam, pp 100–107

    Google Scholar 

  37. Zülch KJ (1980) Principles of the new World Health Organization (WHO) classification of brain tumours. Neuroradiol 19: 59–66

    Google Scholar 

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Steiger, H.J., Markwalder, R.V., Seiler, R.W. et al. Early prognosis of supratentorial grade 2 astrocytomas in adult patients after resection or stereotactic biopsy. Acta neurochir 106, 99–105 (1990). https://doi.org/10.1007/BF01809449

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