Supratentorial low-grade astrocytomas in adults.
One hundred seventy-nine adult patients with supratentorial low-grade astrocytomas were treated during a 10-year period. Retrospectively, a series of nine factors were evaluated with simple and multivariate analysis to determine their importance in predicting length of survival. Four appear highly significant (P < 0.005): age, preoperative Karnofsky Performance Scale score, histological grade, and type of surgical removal. Eighty percent of patients with total removal were alive at 5 years compared with 50% with incomplete surgery and 45% with biopsy. For the group under study, the mean time for recurrence was 52 months. For patients surviving for more than 1 year, the chance of being recurrence free went from 75% at 3 years to 25% at 10 years. Among the entire population, the influence of radiotherapy was not obvious: 65% of patients were alive at 5 years without radiotherapy compared with 55% with radiotherapy. A significant difference appeared only for patients older than 40, with incomplete removal (P < 0.05); this difference did not apply to younger patients. The need for postoperative radiotherapy in all patients with subtotal removal, irrespective of their age, has not been demonstrated by this study.
Philippon
J H
JH
Department of Neurosurgery, Hopital de la Salpetriere, Paris, France.
Clemenceau
S H
SH
Fauchon
F H
FH
Foncin
J F
JF
D000328:Adult; D001254:Astrocytoma / Q000532:radiotherapy / Q000601:surgery*; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D002531:Cerebellum; D003131:Combined Modality Therapy; D006801:Humans; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis