Prognostic Factors and Nomogram Predicting Survival in Diffuse Astrocytoma

Area of Science:

• Neuro-oncology
• Clinical Prognostics
• Epidemiology

Background:

• Genetic markers for low-grade glioma prognosis are not universally accessible.
• Diffuse astrocytoma (DA) is the most prevalent type of low-grade glioma.
• There is a need for accessible prognostic tools for DA.

Purpose of the Study:

• To develop and validate a nomogram for predicting survival in diffuse astrocytoma patients.
• To utilize readily available clinical parameters for prognostic assessment.
• To improve survival prediction accuracy for DA.

Main Methods:

• Retrospective analysis of adult DA patients from three Thai university hospitals.
• Cox regression analysis to identify significant survival-associated factors.
• Development and performance evaluation of a predictive nomogram for 1-year mortality.

Main Results:

• Age ≥60 years, poor Glasgow Coma Scale motor response, and biopsy were significant predictors of survival.
• The nomogram achieved a 1-year mortality prediction accuracy of 0.64 with an Area Under the Curve of 0.75.
• High sensitivity (1.0) and negative predictive value (1.0) were observed for 1-year mortality prediction.

Conclusions:

• A novel nomogram for predicting diffuse astrocytoma prognosis was developed.
• The nomogram demonstrates acceptable performance in predicting 1-year mortality.
• This tool offers a practical alternative for prognosis assessment in resource-limited settings.