Supratentorial low-grade astrocytomas in adults

Area of Science:

• Neuro-oncology
• Neurosurgery
• Oncology

Background:

• Low-grade astrocytomas represent a significant challenge in neuro-oncology.
• Understanding prognostic factors is essential for optimizing patient management and treatment strategies.

Purpose of the Study:

• To identify key factors predicting survival in adult patients with supratentorial low-grade astrocytomas.
• To evaluate the impact of surgical removal extent and radiotherapy on patient outcomes.

Main Methods:

• Retrospective analysis of 179 adult patients treated over a 10-year period.
• Evaluation of nine potential prognostic factors using univariate and multivariate analyses.
• Assessment of survival rates based on age, Karnofsky Performance Scale score, histological grade, and surgical intervention type.

Main Results:

• Age, preoperative Karnofsky Performance Scale score, histological grade, and extent of surgical removal were significant predictors of survival (P < 0.005).
• Five-year survival rates were 80% for total removal, 50% for incomplete surgery, and 45% for biopsy.
• Radiotherapy did not show an obvious influence on overall survival, except in older patients (>40 years) with incomplete removal.

Conclusions:

• Surgical removal extent is a critical determinant of long-term survival in low-grade astrocytomas.
• The routine need for postoperative radiotherapy in all subtotal removal cases, regardless of age, is not supported by this study.
• Further research may refine treatment protocols based on individual prognostic factors.