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Analysis of the mortality probability of preoperative MRI features in malignant astrocytomas
Mehmet Ali Ekici1, Turgay Bulut, Bulent Tucer
1Yunus Emre State Hospital, Neurosurgery Clinic, Eskisehir, Turkey. mehmetali.ekici@gmail.com
Aim:
The aim of the present study is to analyze the effects of the MRI features on the recurrence time and prognosis, and to emphasize the analyses of mortality risks in malignant astrocytomas.
Material And Methods:
The effects of preoperative MRI features on prognosis were studied for follow-up period of 45 months, from November 1999 to August 2003, on a total of 79 patients' 41 cases of total resection and 38 cases of subtotal resection diagnosed to have malignant astrocytoma subsequent to craniotomy.
Results:
The cases of gross total resection had 2.2 times as high survival rate as those in the subtotal resection group (p < 0.01). The comparison of the cases in the groups in relation to their ages revealed that mortality rate rose 4.35 times (p < 0.01) in the age group of 60 years and above, and 2.1 times in the age group of 45-59 years. When cases without necrosis were compared with the group containing necrosis of grade 1, 2, 3, it was observed that the probability of mortality increased 3.84 (p < 0.01), 4.15 times (p < 0.01) in the case of necrosis of grade 2 and 3, respectively by means of Cox regression model.
Conclusion:
Necrosis in preoperative MRI of malignant astrocytomas seems to be an important clinical marker of the prognosis.
Insights
Preoperative MRI features, particularly necrosis, significantly impact malignant astrocytoma prognosis. Necrosis grade 2 or 3 on MRI indicates a higher mortality risk, influencing patient outcomes.
Area of Science:
- Neuro-oncology
- Radiology
- Neurosurgery
Background:
- Malignant astrocytomas are aggressive brain tumors with variable prognoses.
- Accurate prognostic markers are crucial for guiding treatment and patient management.
- Magnetic Resonance Imaging (MRI) offers detailed insights into tumor characteristics.
Purpose of the Study:
- To investigate the influence of preoperative MRI findings on the recurrence time and prognosis of malignant astrocytomas.
- To specifically analyze mortality risks associated with various MRI features in these tumors.
Main Methods:
- A cohort of 79 patients with malignant astrocytoma was studied over a 45-month period.
- Patients underwent craniotomy with either gross total resection (41 cases) or subtotal resection (38 cases).
- Preoperative MRI features, including necrosis, were correlated with patient survival and mortality using Cox regression analysis.
Main Results:
- Gross total resection was associated with a significantly higher survival rate (2.2 times) compared to subtotal resection (p < 0.01).
- Advanced age increased mortality risk, with rates rising 4.35 times in patients aged 60+ and 2.1 times in those aged 45-59.
- The presence and grade of necrosis on preoperative MRI significantly elevated mortality risk: grade 2 necrosis increased risk by 3.84 times, and grade 3 by 4.15 times (p < 0.01).
Conclusions:
- Necrosis identified on preoperative MRI is a critical prognostic indicator for malignant astrocytomas.
- MRI features provide valuable clinical information for predicting patient outcomes and mortality risk.
- Further research into integrating MRI-based prognostic factors into clinical decision-making is warranted.
