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Can quantifying the extent of 'high grade' features help explain prognostic variability in anaplastic astrocytoma?
Goacher, Edward; Mathew, Ryan; Fayaye, Oluwafikayo; Chakrabarty, Aruna; Feltbower, Richard; Loughrey, Carmel; Roberts, Paul; Chumas, Paul.
Afiliación
  • Goacher E; Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK.
  • Mathew R; Department of Neurosurgery, Leeds General Infirmary, Leeds, UK.
  • Fayaye O; School of Medicine, University of Leeds, Leeds, UK.
  • Chakrabarty A; Department of Neurosurgery, Leeds General Infirmary, Leeds, UK.
  • Feltbower R; Department of Histopathology, St. James's University Hospital, Leeds, UK.
  • Loughrey C; School of Medicine, University of Leeds, Leeds, UK.
  • Roberts P; Department of Oncology, St. James's University Hospital, Leeds, UK.
  • Chumas P; Department of Cytogenetics, St. James's University Hospital, Leeds, UK.
Br J Neurosurg ; : 1-8, 2020 Dec 30.
Article en En | MEDLINE | ID: mdl-33377401
PURPOSE: Both phenotypic and genotypic variations now underpin glioma classification, thus helping to more accurately guide their clinical management. However, WHO Grade III anaplastic astrocytoma (AA) remains an unpredictable, heterogeneous entity; displaying a variable prognosis, clinical course and treatment response. This study aims to examine whether additional tumour characteristics influence either overall survival (OS) or 3-year survival in AA. MATERIALS AND METHODS: Data were collected on all newly diagnosed cases of AA between 2003 and 2014, followed up for a minimum of 3 years. Molecular information was obtained from case records and if missing, was re-analysed. Histological slides were independently examined for Ki-67 proliferation index, cellularity and number of mitotic figures. Kaplan-Meier and Cox regression analyses were used to assess OS. RESULTS: In total, 50 cases were included with a median OS of 14.5 months (range: 1-150 months). Cumulative 3-year survival was 31.5%. Median age was 50 years (range: 24 - 77). Age, IDH1 mutation status, lobar location, oncological therapy and surgical resection were significant independent prognostic indicators for OS. In cases demonstrating an OS ≥ 3 years (n = 15), Ki-67 index, number of mitotic figures and percentage areas of 'high cellularity' were significantly reduced, i.e. more characteristic of lower-grade/WHO Grade II glioma. CONCLUSIONS: IDH1 status, age, treatment and location remain the most significant prognostic indicators for patients with AA. However, Ki-67 index, mitotic figures and cellularity may help identify AA cases more likely to survive < 3 years, i.e. AA cases more similar to glioblastoma and those cases more likely to survive > 3 years, i.e. more similar to a low-grade glioma.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Br J Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Br J Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido