title: Pre-operative clinical factors predict progression-free survival and tumor recurrence after initial surgery in patients with astrocytomas: A single-center analysis.
abstract: OBJECTIVE
  Pre-operative predictive factors of progression-free survival (PFS) and tumor recurrence after initial surgery are important in counseling patients and decision making. Though PFS after initial surgery in patients with low grade astrocytomas has been described, little is described about PFS in patients with different tumor grades. Our objective was to investigate potential predictive factors of PFS, and devise a scale to predict PFS and tumor recurrence after initial surgery in patients with primary and recurrent astrocytomas of low and high tumor grades.
  
  
  METHODS
  Clinical, radiographic, pathological and treatment data of 62 patients whose initial treatments of primary and recurrent astrocytomas were both surgeries were analyzed, and factors that had significant correlation with PFS was used to devise a scale.
  
  
  RESULTS
  Factors significantly related with PFS were: the time from onset of symptoms to clinical and radiological diagnosis of astrocytomas (Spearman correlation coefficient r=0.298, significance level P=0.019) and with the symptoms of seizures (r=0.292, P=0.021). Patients with age between 30 and 40 years had significant longer PFS than the rest age group (P=0.018, oneway ANOVA). A simple scale (from 0 to 3 points) comprised of the three factors distinguished four groups of patients with significant different post-operative PFS (0 point, 8.0 months; 1 point, 13.7 months; 2 points, 18.0 months; 3 points, 34.5 months) (P=0.004, oneway ANOVA).
  
  
  CONCLUSIONS
  The simple scale we devised comprised of the three pre-operative prognostic factors can significantly distinguish patients with different post-operative survival after initial treatment of astrocytomas with surgery.
authors.affiliation: Shuai Zheng, Department of Neurosurgery, Provincial Hospital Affiliated to Shandong University, No. 324 Jingwu Road, Jinan 250021, P.R. China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Zheng
authors.affiliation: Xianzeng Hou, Department of Neurosurgery, Qianfoshan Hospital affiliated to Shandong University, No. 16766 Jingshi Road, Jinan 250014, P.R. China.
authors.forename: Xianzeng
authors.initials: X
authors.lastname: Hou
authors.affiliation: Shangchen Xu, Department of Neurosurgery, Provincial Hospital Affiliated to Shandong University, No. 324 Jingwu Road, Jinan 250021, P.R. China.
authors.forename: Shangchen
authors.initials: S
authors.lastname: Xu
authors.affiliation: Qi Pang, Department of Neurosurgery, Provincial Hospital Affiliated to Shandong University, No. 324 Jingwu Road, Jinan 250021, P.R. China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Pang
keywords: Astrocytomas; Clinical factors; Progression-free survival; Surgery; Tumor recurrence