title: Survival in granular cell astrocytomas.
abstract: BACKGROUND
  Granular cell astrocytomas (GCAs) are rarely encountered aggressive glial neoplasms. Treatment options comprise surgery, radiotherapy, and chemotherapy. Due to the small number of cases, a standard therapeutic regimen for GCA does not exist.
  
  
  METHODS
  We report on the case of a 64-year-old woman with GCA subjected to tumor biopsy followed by radiochemotherapy with temozolomide. We provide clinical, histopathologic, and magnetic resonance imaging findings as well as a complete follow-up. To assess the relation of age, gender, time of publication, and different treatment options with survival we performed log-rank tests and calculated Cox regression models and hazard ratios in data from all available reports on GCA.
  
  
  RESULTS
  A significant difference in survival rates in favor of adjuvant therapy (radiotherapy or radiochemotherapy) at 12 months was found. Age > 70 years at the time of diagnosis had a significantly unfavorable impact on survival at 12 months. Although not statistically significant, a tendency toward higher probability of survival at 12 months was found in cases reported after 2002. In surgically treated patients, we could not find a significant impact of extent of resection on survival. A significant impact of gender on survival was not found.
  
  
  CONCLUSIONS
  Adjuvant therapy is significantly related to a higher probability of survival at 12 months and may therefore be recommended for patients with a GCA. Further analysis of these rare neoplasms is warranted.
authors: Department of Neurosurgery, Otto von Guericke-University, Magdeburg, Germany.
authors: Benjamin
authors: B
authors: Voellger
authors: Department of Neurosurgery, Otto von Guericke-University, Magdeburg, Germany.
authors: Jorge Humberto
authors: JH
authors: Tapia-Perez
authors: Department of Neurosurgery, Otto von Guericke-University, Magdeburg, Germany.
authors: Rosita
authors: R
authors: Rupa
authors: Department of Neurosurgery, Otto von Guericke-University, Magdeburg, Germany.
authors: Dimitrios
authors: D
authors: Karagiannis
authors: Department of Neuropathology, Otto von Guericke-University, Magdeburg, Germany.
authors: Christian
authors: C
authors: Mawrin
authors: Department of Neuropathology, Otto von Guericke-University, Magdeburg, Germany.
authors: Elmar
authors: E
authors: Kirches
authors: Department of Neurosurgery, Otto von Guericke-University, Magdeburg, Germany.
authors: Thomas
authors: T
authors: Schneider
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000494:pharmacology; D001254:Astrocytoma / Q000401:mortality* / Q000628:therapy*; D001932:Brain Neoplasms / Q000401:mortality* / Q000628:therapy*; D002648:Child; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000494:pharmacology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009778:Occipital Lobe / Q000473:pathology; D018714:Radiotherapy, Adjuvant; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide