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Related Experiment Videos

Pleomorphic xanthoastrocytoma: what do we really know about it?

C Giannini1, B W Scheithauer, P C Burger

  • 1Department of Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA.

Cancer
|May 1, 1999
PubMed
Summary

Pleomorphic xanthoastrocytomas (PXA) can recur, but prognosis is generally favorable. Mitotic index and extent of resection are key predictors of recurrence-free and overall survival in these rare brain tumors.

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Area of Science:

  • Neuro-oncology
  • Surgical Pathology
  • Clinical Neurology

Background:

  • Pleomorphic xanthoastrocytomas (PXA) are rare brain tumors with a significant recurrence rate (15-20%) and associated mortality.
  • Currently, no definitive histopathologic features reliably predict PXA recurrence or progression.

Purpose of the Study:

  • To identify histopathologic and clinical factors that predict recurrence-free survival (RFS) and overall survival (OS) in patients with PXA.
  • To evaluate the prognostic significance of various tumor features and treatment modalities.

Main Methods:

  • Retrospective analysis of 71 PXA cases with clinical, therapeutic, and follow-up data.
  • Evaluation of diagnostic features including cellular pleomorphism, giant cells, eosinophilic granular bodies, desmoplasia, leptomeningeal involvement, mitotic index (MI), necrosis, and endothelial proliferation.

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  • Statistical analysis using univariate and multivariate models to determine predictors of RFS and OS.

    • Main Results:

    • The study included 71 patients (35 female, 36 male), with tumors predominantly supratentorial (98%) and in the temporal lobe (49%). Seizures were the most common presenting symptom (71%).
    • Recurrence-free survival (RFS) rates were 72% at 5 years and 61% at 10 years. Overall survival (OS) rates were 81% at 5 years and 70% at 10 years.
    • Extent of resection and mitotic index (MI) were significant independent predictors of RFS. MI was the sole independent predictor of OS.

    Conclusions:

    • Pleomorphic xanthoastrocytoma (PXA) exhibits a relatively favorable prognosis.
    • The mitotic index (MI) and the extent of tumor resection are the primary prognostic factors influencing both recurrence-free and overall survival.
    • Further studies with larger cohorts and longer follow-up are needed to fully elucidate prognostic factors for PXA.