title: Post-contrast enhancement as a clinical indicator of prognosis in patients with anaplastic astrocytoma.
abstract: Diagnosis of an anaplastic astrocytoma (World Health Organization grade III) is associated with a highly variable prognosis. The identification of clinical markers that allow a more careful delineation of this prognostic spectrum is urgently needed. In this study, we analysed 48 patients with a histological diagnosis of anaplastic astrocytoma and found peritumoral post-gadolinium contrast enhancement to be a clear prognostic marker of poor prognosis. Multivariate analysis also confirmed surgery type, Karnofsky Performance Status score (<70) and increasing age as independent adverse predictors of survival. The survival differences observed in the enhancing and non-enhancing lesions in patients diagnosed with anaplastic astrocytoma supports the existence of a broad anaplastic spectrum of disease, with enhancement being a clinical marker of tumour progression along this spectrum.
authors.affiliation: Sydney Medical School, The University of Sydney, New South Wales 2006, Australia.
authors.forename: Elie
authors.initials: E
authors.lastname: Matar
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Cook
authors.forename: Adam R
authors.initials: AR
authors.lastname: Fowler
authors.forename: Michael T
authors.initials: MT
authors.lastname: Biggs
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Little
authors.forename: Helen R
authors.initials: HR
authors.lastname: Wheeler
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Robinson
authors.forename: Kerrie L
authors.initials: KL
authors.lastname: McDonald
mesh_terms: D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000473:pathology*; D001932:Brain Neoplasms / Q000473:pathology*; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D005682:Gadolinium