title: Five-year follow-up results for patients diagnosed with anaplastic astrocytoma and effectiveness of concomitant therapy with temozolomide for recurrent anaplastic astrocytoma.
abstract: BACKGROUND
  Anaplastic astrocytoma (AA; WHO grade-III) patients determination of prognostic factors helps generating multimodal therapy protocols. For this purpose, in the Baskent University, Adana Medical Research Center, specific characteristics of AA patients who have surgery were retrospectively investigated and factors which affect prognosis has been determined.
  
  
  METHODS
  Between January 2005 and 2009, 20 patients who have AA have been evaluated retrospectively. Totally, 20 patients had 31 operations. Sixteen patients had only adjuvant radiation therapy (RT). In the postoperative period, 8 patients received adjuvant RT. Nine of 10 patients with tumor recurrence received concomitant therapy with temozolomide (ConcT with TMZ) protocol. No adjuvant therapy protocol could be applied in three patients with poor general condition in the postoperative period.
  
  
  RESULTS
  Median survival for patients died was 16±17 months; one year survival was 75% and five year survival 25%. After univariate analysis, preoperative Karnofsky performance score (KPS) was ≥80 (P=0.005577(*)), postoperative KPS was ≥80 (P=0.003825(*)), type of tumor resection (P=0.001751(*)), multiple operations (P=0.006233(*)), and ConcT with TMZ protocol (P=0,005766(*)) were all positive prognostic factors which extend the survival.
  
  
  CONCLUSIONS
  The results of the multivariate analysis did not put forward an independent prognostic factor acting on the survival period (P>0.05).
authors.affiliation: Department of Neurosurgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Feyzi Birol
authors.initials: FB
authors.lastname: Sarica
authors.forename: Melih
authors.initials: M
authors.lastname: Cekinmez
authors.forename: Kadir
authors.initials: K
authors.lastname: Tufan
authors.forename: Orhan
authors.initials: O
authors.lastname: Sen
authors.forename: Huseyin C
authors.initials: HC
authors.lastname: Onal
authors.forename: Huseyin
authors.initials: H
authors.lastname: Mertsoylu
authors.forename: Erkan
authors.initials: E
authors.lastname: Topkan
authors.forename: Berrin
authors.initials: B
authors.lastname: Pehlivan
authors.forename: Bulent
authors.initials: B
authors.lastname: Erdogan
authors.forename: Mehmet N
authors.initials: MN
authors.lastname: Altinors
keywords: Anaplastic astrocytoma; concomitant therapy; prognostic factor; recurrence; temozolomide
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