Clinical Factors for Prognosis and Treatment Guidance of Spinal Cord Astrocytoma
| Autor: | Toshitaka Seki, Kazutoshi Hida, Shunsuke Yano, Takeshi Aoyama, Izumi Koyanagi, Toru Sasamori, Shuji Hamauch, Kiyohiro Houkin |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: | |
| Zdroj: | Asian Spine Journal, Vol 10, Iss 4, Pp 748-754 (2016) |
| Druh dokumentu: | article |
| ISSN: | 1976-1902 1976-7846 |
| DOI: | 10.4184/asj.2016.10.4.748 |
| Popis: | Study DesignRetrospective study.PurposeTo obtain information useful in establishing treatment guidelines by evaluating baseline clinical features and treatment outcomes of patients with spinal cord astrocytoma (SCA).Overview of LiteratureThe optimal management of SCA remains controversial, and there are no standard guidelines.MethodsThe study included 20 patients with low-grade and 13 with high-grade SCA surgically treated between 1989 and 2014. Patients were classified according to the extent of surgical resection. Survival was assessed using Kaplan–Meier plots and compared between groups by log-rank tests. Neurological status was defined by the modified McCormick scale and compared between groups by Mann–Whitney U tests.ResultsSurgical resection was performed for 19 of 20 low-grade (95%) and 10 of 13 high-grade (76.9%) SCA patients. Only nine patients (27.3%) underwent gross total resection, all of whom had low-grade SCA. Of all patients, 51.5% showed deteriorated neurological status compared to preoperative baseline. Median overall survival was significantly longer for low-grade SCA than that (91 months, 78% at 5 years vs. 15 months, 31% at 5 years; p=0.007). Low-grade SCA patients benefited from more aggressive resection, whereas high-grade SCA patients did not. Multivariate analysis revealed histology status (hazard ratio [HR], 0.30; 95% confidence interval [CI], 0.09–0.98; p |
| Databáze: | Directory of Open Access Journals |
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