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Prognostic factors in adult brainstem glioma: a tertiary care center analysis and review of the literature
- Source :
- Journal of neurology. 269(3)
- Publication Year :
- 2021
-
Abstract
- Introduction Adult brainstem gliomas (BSGs) are rare central nervous system tumours characterized by a highly heterogeneous clinical course. Median survival times range from 11 to 84 months. Beyond surgery, no treatment standard has been established. We investigated clinical and radiological data to assess prognostic features providing support for treatment decisions. Methods 34 BSG patients treated between 2000 and 2019 and aged ≥ 18 years at the time of diagnosis were retrospectively identified from the databases of the two largest Austrian Neuro-Oncology centres. Clinical data including baseline characteristics, clinical disease course, applied therapies, the outcome as well as neuroradiological and neuropathological findings were gathered and analysed. The tumour apparent diffusion coefficient (ADC), volumetry of contrast-enhancing and non-contrast-enhancing lesions were determined on magnetic resonance imaging scans performed at diagnosis. Results The median age at diagnosis was 38.5 years (range 18–71 years). Tumour progression occurred in 26/34 (76.5%) patients after a median follow up time of 19 months (range 0.9–236.2). Median overall survival (OS) and progression-free survival (PFS) was 24.1 months (range 0.9–236.2; 95% CI 18.1–30.1) and 14.5 months (range 0.7–178.5; 95% CI 5.1–23.9), respectively. Low-performance status, high body mass index (BMI) at diagnosis and WHO grading were associated with shorter PFS and OS at univariate analysis (p p = 0.018). Conclusion ECOG, BMI, WHO grade and ADC values were associated with the survival prognosis of BSG patients and should be included in the prognostic assessment.
- Subjects :
- Adult
medicine.medical_specialty
Neurology
Adolescent
Tertiary Care Centers
Young Adult
Median follow-up
medicine
Brainstem glioma
Effective diffusion coefficient
Humans
Neuroradiology
Aged
Retrospective Studies
Univariate analysis
medicine.diagnostic_test
business.industry
Brain Neoplasms
Magnetic resonance imaging
Glioma
Middle Aged
medicine.disease
Prognosis
Log-rank test
Neurology (clinical)
Radiology
business
Brain Stem
Subjects
Details
- ISSN :
- 14321459
- Volume :
- 269
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of neurology
- Accession number :
- edsair.doi.dedup.....7e0b139be24334278a274cdfaf731fa4