Prognosis and Treatment of Spinal Cord Astrocytoma

Minehan, Kiernan J.; Brown, Paul D.; Scheithauer, Bernd W.; Krauss, William E.; Wright, Michael P.

doi:10.1016/j.ijrobp.2008.04.060

Cited by 139 publications

(96 citation statements)

References 16 publications

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“…Adams et al [2], using SEER data, found that radiation therapy trended towards a significant association with improved survival in adult HGSCA. Minehan et al [13] studied a spectrum of spinal cord astrocytomas and report postoperative radiation therapy (with a majority of surgical interventions being biopsies and a minority being subtotal or gross total resections) significantly improved survival for patients with infiltrative astrocytomas. Other published studies have not shown significant improvements in survival among those treated with radiation [6,7,14].…”

Section: Discussionmentioning

confidence: 99%

“…For pediatric intracranial high-grade gliomas, complete resection has been demonstrated to have a positive impact on outcome [10,15,16], though the prognostic relevance of total resection in pediatric spinal cord tumors has received mixed reports [2,13,17,18,19]. Wolff et al [6] showed that gross total resection was associated with lower mortality in their series of 28 European children with high-grade glioma of the spinal cord in comparison with other kinds of surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Wolff et al [6] showed that gross total resection was associated with lower mortality in their series of 28 European children with high-grade glioma of the spinal cord in comparison with other kinds of surgical treatment. While multiple papers have analyzed the extent of surgical resection, none have concluded that extent of resection of malignant spinal cord tumors is correlated with survival [7,13,20,21,22,23] with the exception of McGirt et al [19]. In a retrospective series of 35 patients, the authors found that radical resection correlated with longer survival for patients with AA but not with GBM [19].…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Risk Factors and Survival in Pediatric High-Grade Spinal Cord Astrocytoma: A Population-Based Study

Lam¹,

Lin²,

Melkonian

2012

Pediatr Neurosurg

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Background/Aims: Primary pediatric high-grade spinal cord astrocytomas are rare neoplasms with poor prognoses. Using the Surveillance, Epidemiology, and End Results (SEER) database, we analyzed prognostic factors and survival. Methods: Pediatric patients with histologically confirmed diagnoses of primary high-grade spinal cord astrocytoma (WHO grade III-IV) from 1973 to 2008 in the SEER database were studied. Univariate and multivariate Cox proportional hazards models were used to analyze the relationship between demographic, tumor grade, and treatment factors on survival. Results: Median survival in the 48 patient cohort was 10 months. Increasing age and higher tumor grade were found to be significantly associated with higher mortality. For children aged <7, 7-12, and 13-18 years, median survival was 22, 11, and 8 months, respectively. For children with anaplastic astrocytoma (WHO grade III), median survival was 12 months, compared with 7 months for those with glioblastoma multiforme (WHO grade IV). This study did not find a statistically significant relationship between sex, race, presence of radiation therapy or extent of surgical resection and mortality. Conclusion: Survival in primary pediatric high-grade spinal cord astrocytomas was positively associated with younger age and lower tumor grade. Survival was not associated with other demographic or treatment modality factors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Analysis of Risk Factors and Survival in Pediatric High-Grade Spinal Cord Astrocytoma: A Population-Based Study

Lam¹,

Lin²,

Melkonian

2012

Pediatr Neurosurg

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“…Studies report that the outcomes for minimally invasive and open surgery are comparable [10]. In our series of minimally invasive surgery, meningioma was the most frequent tumor (37.5%) with a complete resection rate of 73.3% and a subtotal resection of 20%.…”

Section: Discussionmentioning

confidence: 54%

Minimally Invasive Surgical Approach for Spinal Canal Tumors—Technique Description and Experience from a Reference Center

Berbeo¹,

Díaz²,

Pérez³

et al. 2017

JCT

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Background: Spinal canal tumors are difficult to diagnose and treat. The traditional surgical approaches for attempting a complete excision of these lesions frequently involve big incisions and tissue dissection with high risk of postop instability and cerebrospinal fluid leakage. Also, there is a risk of neurological worsening, sometimes irreversible. Methods: We present our experience in a patient series with spinal canal tumors and describe the surgical approach with minimally invasive techniques (MIS). All of them were performed by the Neurosurgery team of the Hospital Universitario San Ignacio during the period of 2011-2016. Results: We reviewed forty patients with spinal canal tumors surgically treated with MIS techniques. 15 patients (37.5%) had Meningioma diagnosis (complete resection in 11 (73.3%), subtotal in 3 (20%) and biopsy in one patient), 10 patients (25%) with Schwannomas reached complete resection in 70% and subtotal in 30%. 5 patients had spinal cord metastasis, with complete resection in 4 patients (80%) and subtotal in 1 (20%). Other included ependymoma, astrocytoma, and miscellaneous. No patient has had cerebrospinal fluid leakage and no postoperative fusion has been required. Conclusions: The minimally invasive approach allowed complete tumors removal in a high number of patients and good postoperative results. These findings are similar and in some cases, better than the reported with traditional techniques. This MIS technique provides encouraging results. It requires a wide learning curve and a high degree of surgical experience.

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“…Adjuvant radiotherapy is indicated for patients with high grade histology, incomplete resection and those with progressive disease and has shown to improve survival [5,6]. Treatment of high grade glioma of spinal cord consists of maximal safe resection followed by external beam radiotherapy [1].…”

Section: Oncology Section Abstractmentioning

confidence: 99%

An Unusually Long Survival of A Patient with Glioblastoma of Spinal Cord: A Case Report

Varghese

Sebastian

Joseph

et al. 2014

JCDR

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A 22-year-old gentleman presented in December 2006 with a short one-month history of progressive weakness of bilateral lower limbs, decreased sensation below the mid chest level, urinary hesitancy with a sense of incomplete evacuation of the bladder. On examination, the tone was spastic in both lower limbs with power of grade 0 and absence of all modalities of sensation below T4 level bilaterally. MRI spine showed a diffuse contrast enhancing intramedullary mass from D3 to D6 level [ Fig-5a and 5b]. The MIB-1 labelling index was 10% [Table/ Fig-6]. Despite the absence of necrosis, a diagnosis of Glioblastoma was considered owing to the presence of microvascular proliferation.Postoperatively, he was treated with conventional radiation therapy, 5040 cGy in 28 fractions, five fractions per week. Physiotherapy and occupational therapy were continued and he had neurological improvement with grade 4 power in right lower limb, left thigh and knee, and grade 2 powers in left ankle dorsiflexion. Sensation recovered completely. He was able to void normally at this time.[Table/ Fig-7] shows the imaging at the follow up visit in May 2008.In April 2012, he presented with increased low backache and tightness of left lower limb of one month duration with reduction in power in the left lower limb to grade 2. There was decreased sensation along the L3 to L5 dermatomes. MRI spine showed recurrent contrast enhancing lesions in mulltiple levels, largest lesion at L1/L2 levels and L5 levels [Table/ Fig-8]. He received radiotherapy to the lumbar lesion -50 Gy in 25 fractions by three dimensional conformal techniques. The power in left lower limb improved to grade 4, and he was able to carry out activities of daily living without support.In July 2013, he developed giddiness and vomiting with postural imbalance of one month duration and was found to have a left cerebellopontine (CP) angle tumour with infiltration of the cerebellum, midbrain and pons [Table/ Fig-9]. He received palliative radiotherapy to whole brain, 36 Gy in 12 fractions using conventional technique. He was also started on chemotherapy with Temozolomide (TMZ). He is alive continuing chemotherapy currently at the point of reporting this case with good quality of life and abilities to do activities of daily living but with residual minimal incoordination. Oncology Section aBstRaCtPrimary glioblastoma of spinal cord are rare and are associated with poor survival especially in adults. We report a case of glioblastoma of thoracic spinal cord (D3 to D6) in an adult treated with partial resection surgery and radiation therapy with a survival of six years with good quality of life. The patient had paraplegia at presentation but improved after surgery and radiation therapy to grade 4 in both lower limbs. After 5 years, he developed new lesion in a different location of the spine (L1, L2 & L5) along with multiple lesions over entire spine and was treated with radiation therapy and a year later developed a new lesion intracranially in the posterior fossa involving cerebelloponti...

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Prognosis and Treatment of Spinal Cord Astrocytoma

Cited by 139 publications

References 16 publications

Analysis of Risk Factors and Survival in Pediatric High-Grade Spinal Cord Astrocytoma: A Population-Based Study

Analysis of Risk Factors and Survival in Pediatric High-Grade Spinal Cord Astrocytoma: A Population-Based Study

Minimally Invasive Surgical Approach for Spinal Canal Tumors—Technique Description and Experience from a Reference Center

An Unusually Long Survival of A Patient with Glioblastoma of Spinal Cord: A Case Report

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