Prognostic factors and survival in low grade gliomas of the spinal cord: A population-based analysis from 2006 to 2012.

Autor: Diaz-Aguilar D; Department of Neurosurgery, David Geffen School of Medicine, Los Angeles, CA, USA., ReFaey K; Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA., Clifton W; Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA., Durcanova B; Department of Neurosurgery, UCSF, San Francisco, CA, USA., Chen SG; Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA., Deen HG; Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA., Bydon M; Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA., Trifiletti DM; Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA., Pichelmann MA; Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA., Quiñones-Hinojosa A; Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA. Electronic address: quinones@mayo.edu.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2019 Mar; Vol. 61, pp. 14-21. Date of Electronic Publication: 2018 Dec 06.
DOI: 10.1016/j.jocn.2018.11.025
Abstrakt: Purpose: Primary spinal cord tumors are rare, and evidence-based management of these patients remains a source of controversy. This study used a large cohort of low-grade spinal cord astrocytomas to determine the effectiveness of prognostic factors and survival.
Methods: The Surveillance, Epidemiology, and End Results (SEER) cancer registry was used to identify patients with WHO grade I-II primary spinal cord astrocytomas from 1973 to 2012; however, patients before 2006 were excluded due to ambiguity diagnosis. Univariate and multivariate Cox proportional hazard models were created to compare survival across covariates and summarized using the Kaplan-Meier method.
Results: A total of 561 patients with low-grade glioma (astrocytoma) were identified. Among these, 15.5% of patients received a gross total resection (GTR), 26.1% subtotal resection (STR), and 46.2% unidentified extent of resection. 59.4% did not receive any radiation therapy at any point of the treatment course, while 40.6% underwent radiation therapy. In our cohort, only patients with GTR demonstrated statistically improved survival (HR: 0.22, P < 0.001). Patients with STR had nearly identical survival compared to patients with no surgery (HR: 0.98), and radiotherapy was associated with increased odds of mortality (HR: 1.47, P < 0.001). Multivariate analysis demonstrated a significant survival benefit among patients with younger age, GTR and absence of radiotherapy. Histologic grade did not statistically impact survival.
Conclusion: Our study suggests that GTR results in improved survival among patients with low-grade gliomas within the spinal cord. Future, considerable data research efforts will aim to better define the role of radiotherapy and tumor grading in this patient population.
(Copyright © 2018. Published by Elsevier Ltd.)
Databáze: MEDLINE
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