Corpus callosum involvement as a prognostic factor for patients with high-grade astrocytoma.
OBJECTIVE
To evaluate corpus callosum involvement as a prognostic factor for patients with high-grade astrocytoma.


METHODS
From 1986 through 1994, 141 adult patients with Karnofsky performance status (KPS) > or = 40 underwent primary treatment for anaplastic astrocytoma (AA) or glioblastoma multiforme (GBM) at the University of Washington Medical Center. Preoperative magnetic resonance imaging and/or computed tomography to assess corpus callosum involvement was available for 105 of these patients. Corpus callosum involvement was evaluated as a prognostic factor for survival using recursive partitioning analysis and multivariate analysis with a Cox proportional hazards model.


RESULTS
For the 105 patients evaluable for corpus callosum involvement, the median and 2-year survival were 59 weeks and 28%, respectively. On multivariate analysis, the only independent prognostic factors were KPS (p = 0.0001) and histology (p = 0.042). On recursive partitioning analysis, the first significant split occurred at KPS < 70 vs. KPS > or = 70. Patients with KPS > or = 70 were split by age (< 50 years vs. > or = 50 years), with those younger than 50 years further split by absence or presence of corpus callosum involvement. Among patients with KPS > or = 70 and age < 50 years, median survival was 57 weeks if the corpus callosum was involved (35% 2-year survival) and 105 weeks if the corpus callosum was not involved (56% 2-year survival).


CONCLUSIONS
Corpus callosum involvement based on preoperative imaging is an unfavorable prognostic factor for survival among the subgroup of young, good-performance-status patients with high-grade astrocytoma.
Steltzer
K J
KJ
Department of Radiation Oncology, University of Washington Medical Center, Seattle 98195, USA.
Sauvé
K I
KI
Spence
A M
AM
Griffin
T W
TW
Berger
M S
MS
D001932:Brain Neoplasms / Q000473:pathology*; D003337:Corpus Callosum / Q000473:pathology*; D005909:Glioblastoma / Q000473:pathology*; D006801:Humans; D017567:Karnofsky Performance Status; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models