title: Analysis of prognostic and survival factors related to treatment of low-grade astrocytomas in adults.
abstract: 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 associated 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.
authors.affiliation: Department of Neurosurgery, Nara Medical University, Nara, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nakamura
authors.forename: N
authors.initials: N
authors.lastname: Konishi
authors.forename: S
authors.initials: S
authors.lastname: Tsunoda
authors.forename: H
authors.initials: H
authors.lastname: Nakase
authors.forename: T
authors.initials: T
authors.lastname: Tsuzuki
authors.forename: H
authors.initials: H
authors.lastname: Aoki
authors.forename: H
authors.initials: H
authors.lastname: Sakitani
authors.forename: T
authors.initials: T
authors.lastname: Inui
authors.forename: T
authors.initials: T
authors.lastname: Sakaki
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D017209:Apoptosis; D001254:Astrocytoma / Q000737:chemistry / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D001932:Brain Neoplasms / Q000737:chemistry / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000235:genetics
chemical_list: D016159:Tumor Suppressor Protein p53