Brain Tumor Res Treat.  2019 Oct;7(2):92-97. 10.14791/btrt.2019.7.e36.

Survival and Prognosis of Patients with Pilocytic Astrocytoma: A Single-Center Study

• Park JH
• Jung N
• Kang SJ
• Kim HS
• Kim E
• Lee HJ
• Jung HR
• Choe M
• Shim YJ

• KMID: 2461181
• DOI: http://doi.org/10.14791/btrt.2019.7.e36

Abstract

BACKGROUND
Pilocytic astrocytoma (PA) is a brain tumor that is relatively more common in children and young adults.
METHODS
We retrospectively reviewed the medical records of patients with PA treated at a single center between 1988 and 2018.
RESULTS
We included 31 subjects with PA. The median age at diagnosis was 13.4 years, and the median follow-up duration was 9.9 years. The total PA group had a 10-year disease-specific survival (DSS) rate of 92.6% [95% confidence interval (CI), 82.6-100] and 10-year progression-free survival (PFS) rate of 52.8% (95% CI, 32.0-73.6). In patients aged <20 years, tumors were more likely to be located in sites in which gross total tumor resection (GTR) was impossible. No statistically significant difference in 10-year DSS was found between the GTR (100%) and non-GTR (89.7%; 95% CI, 76.2-100; p=0.374) groups. However, a statistically significant difference in 10-year PFS was found between the GTR (100%) and non-GTR groups (30.7%; 95% CI, 8.6-52.8; p=0.012). In the non-GTR group, no statistically significant difference in 10-year DSS was found between the patients who received immediate additional chemotherapy and/or radiotherapy (Add-Tx group, 92.9%; 95% CI, 79.4-100) and the non-Add-Tx group (83.3%; 95% CI, 53.5-100; p=0.577). No statistically significant difference in 10-year PFS was found between the Add-Tx group (28.9%; 95% CI, 1.7-56.1) and non-Add-Tx group (33.3%; 95% CI, 0-70.9; p=0.706).
CONCLUSION
The PFS of the patients with PA in our study depended only on the degree of surgical excision associated with tumor location. This study is limited by its small number of patients and retrospective nature. A multicenter and prospective study is necessary to confirm these findings.

Keyword

Glioma; Survivors; Child; Adolescent; Prognosis

MeSH Terms

Adolescent
Astrocytoma*
Brain Neoplasms
Child
Diagnosis
Disease-Free Survival
Drug Therapy
Follow-Up Studies
Glioma
Humans
Medical Records
Prognosis*
Prospective Studies
Radiotherapy
Retrospective Studies
Survivors
Young Adult

Figure

• 

  Fig. 1 The ratio of glial tumors between age groups in a single medical center between1988 and 2018. A: A total of 1,017 patients had pathologically confirmed primary brain tumors; of them, 314 had glial tumors. Pilocytic astrocytoma occurred more frequently in patients aged <20 years (20.8%) than in those aged ≥20 years (1.2%; p<0.001). B: The ratio of pilocytic astrocytoma among the patients aged <20 years was 64.5%.

• 

  Fig. 2 The survival rate of the patients with pilocytic astrocytoma in a single center. The 10-year DSS, OS, and PFS were 92.6% (95% CI, 82.6–100), 88.4% (95% CI, 66.4–98.6), and 52.8% (95% CI, 32.0–73.6). DSS, disease-specific survival; OS, overall survival; PFS, progression-free survival; CI, confidence interval.

• 

  Fig. 3 Survival rates of the patients with pilocytic astrocytoma according to resection success. No statistically significant difference in 10-year DSS was found between the GTR and non-GTR groups (A and C). However, a statistically significant difference in 10-year PFS was observed between the GTR and non-GTR groups (B and D). DSS, disease-specific survival; PFS, progression-free survival; GTR, gross total resection; STR, subtotal tumor resection; PTR, partial tumor resection.

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