Analysis of prognostic and survival factors related to treatment of low-grade astrocytomas in adults

Prognostic factors for low-grade astrocytomas have been proposed, but optim al treatment remains controversial. Eighty-eight consecutive adult patients with supratentorial low-grade astrocytomas were retrospectively reviewed t o determine specific factors influencing outcome. All underwent craniotomy (43 radical resections, 45 nonradical resections). Sex, age at diagnosis, p reoperative Karnofsky performance status (KPS), tumor location, estimated e xtent of resection, radiation, chemotherapy, histological type, p53 status, MIB-1 staining and the apoptotic index were assessed as parameters for pro gnostic significance. KPS (p = 0.03), tumor location (p < 0.001), extent of surgical resection (p < 0.001) and radiotherapy (p = 0.01) were significan tly assoicated with longer survival rates by univariate analysis. Multivari ate analysis also showed a significant correlation between radiation therap y after surgical removal and survival time (p < 0.001), p53 status was not of importance in determining the necessity for radiotherapy. Radical surgic al removal is the most important factor in the management of low-grade astr ocytomas. Radiation therapy appears to be effective in improving the progno sis regardless of the extent of surgical resection or the p53 status. Copyr ight (C) 2000 S. Karger AG, Basel