Treatment Outcomes and Prognostic Factors in Adult Astrocytoma: In North East of Iran.
BACKGROUND
Astrocytomas are the most common primary adult brain tumors.


OBJECTIVE
In this study, we investigated the impact of some potential prognostic factors on survival in patients with low and high grade astrocytomas.


METHODS
This retrospective cohort study was performed on patients with brain astrocytoma who were referred to oncology departments, Omid and Ghaem hospitals, Mashhad University of Medical Sciences (2000 - 2011).


RESULTS
415 patients with a median age of 43 and a male to female ratio of 252:163 (1.54) were recorded. Grade I to IV astrocytoma were found in 40 (9.6%), 88 (21.2%), 71 (17.1%) and 216 (52%) patients. With a median follow up time of 37 months for low grade and 13 months for high grade astrocytoma, the 5-year survival in grades I to IV was 92.1%, 69.1%, 49.2% and 9.6% respectively. In low grade astrocytomas, patients with grade I tumors, being ambulatory (5-year survival: 88% vs. 60.3%, P < 0.001) and performing optimal surgery (5-year survival 86% vs. 59.3%, P < 0.001) were associated with more favorable survival. In high grade astrocytomas, patients with grade III tumors, age < 50 (5-year survival 29.6% vs. 14.6%, P < 0.001), being ambulatory (5-year survival 39.4% vs. 10.5, P < 0.001), performing optimal surgery (5-year survival 46.1% vs. 4.3%, P < 0.001) and receiving chemotherapy (5-year survival 23.7% vs. 18.7%, P = 0.02) were associated with significantly higher overall survival.


CONCLUSIONS
Performing optimal surgery and good performance status were associated with more favorable survival in both low and high grade astrocytomas. In high grade a strocytomas, patients younger than 43 and those who received chemotherapy had better overall survival.
Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Kazem
K
Anvari
Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Mehdi
M
Seilanian Toussi
Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Soodabeh
S
Shahidsales
Department of Neurosurgery, Aria & Farabi Hospitals, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, IR Iran.
Farhad
F
Motlagh
Department of Neurosurgery, Shahid Kamiab Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Mohammad
M
Reza Ehsaee
Department of Radiation Oncology, Omid Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Farzaneh
F
Afshari
Astrocytoma; Overall Survival; Prognostic Factor