SPINAL-CORD ASTROCYTOMA - PATHOLOGICAL AND TREATMENT CONSIDERATIONS

Seventy-nine patients underwent surgery, with or without radiation the rapy, for astrocytoma of the spinal cord. There were 43 tumors (54%) c lassified as pilocytic astrocytoma and 25 (32%) as diffuse fibrillary astrocytoma. Eleven tumors (14%) could not be classified other than as astrocytoma, ''type not otherwise specified.'' The 10-year overall su rvival rate for all 79 patients was 50% but significantly differed by histological type: 81% for patients with pilocytic astrocytoma compare d to 15% for those with diffuse fibrillary astrocytoma. Tumor grade by the Kernohan, et nl., or St. Anne-Mayo methods was also a significant predictor of survival in patients with diffuse fibrillary astrocytoma . The extent of surgical resection (biopsy vs. subtotal resection vs. gross total resection) did not significantly impact survival among pat ients with pilocytic or nonpilocytic astrocytomas of the spinal cord, although there was a trend toward poorer survival in patients undergoi ng some degree of resection as opposed to biopsy. Postoperative radiat ion therapy improved survival but did so more for diffuse fibrillary a strocytoma than pilocytic astrocytoma. In this series, histological ty pe was the most significant predictor of survival in patients with ast rocytoma of the spinal cord. The survival rate was highest in patients who underwent biopsy followed by postoperative radiation therapy.