Treatment, prognostic factors, and outcomes in spinal cord astrocytomas

Mohamad H. Fakhreddine, Anita Mahajan, Marta Penas-Prado, Jeffrey Weinberg, Ian E. McCutcheon, Vinay Puduvalli, Paul D. Brown

Research output: Contribution to journalReview articlepeer-review

44 Scopus citations

Abstract

Background. Spinal astrocytomas are rare intramedullary CNS tumors for which there is limited consensus on treatment; the importance of the extent of resection (EOR), postoperative radiotherapy, and chemotherapy remains poorly understood. We report on outcomes associated with surgery, postoperative radiotherapy, and chemotherapy in a series of patients treated at M. D. Anderson Cancer Center (MDACC) with the aim of elucidating the role of these treatments in spinal astrocytomas. Methods. We retrospectively reviewed charts from a series of 83 patients with histologically confirmed spinal astrocytoma treated at MDACC during 1990- 2011. Data collected included patient demographic characteristics, prognostic indicators, and treatment modality at diagnosis. We analyzed overall survival (OS) and progression-free survival (PFS) for pilocytic (World Health Organization [WHO] grade I) and infiltrative (WHO grades II, III, and IV) astrocytomas, separately. Multivariate analysis was performed for the infiltrative patients but not the pilocytic patients because of a limited number of cases. Results. Higher WHO grade among all patients was associated with worse OS (P <.0001) and PFS (P = .0003). Among patients with infiltrative tumors, neither EOR nor radiotherapy was associated with a difference in outcomes in multivariate analysis; however, among patients with infiltrative astrocytomas, chemotherapy was significantly associated with improved PFS (hazard ratio = .22, P = .0075) but not OS (hazard ratio = .89, P = .83) in multivariate analysis. Conclusion. WHO grade was the strongest prognostic indicator in patients with spinal cord astrocytomas.

Original languageEnglish (US)
Pages (from-to)406-412
Number of pages7
JournalNeuro-oncology
Volume15
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

Keywords

  • Chemotherapy
  • Glioma
  • Intramedullary
  • Management prognosis

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology
  • Cancer Research

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