성인 털모양별아교세포종의 임상양상 및 예후인자에 대한 후향적 분석 연구

Abstract

Abstract Background Pilocytic astrocytomas (PAs) frequently affect the pediatric population. On the contrary, only rare case series in adults were reported. Some reported adult PA represented more aggressive behavior than pediatric patients but it is a relatively unknown entity about their prognosis and management. The goal of this study is to evaluate prognostic factors and treatment outcomes in adult PA patients to assess overall prognosis after surgery.

Methods We reviewed 71 adult patients diagnosed of PA in single institution between 1999 and 2017. We investigated OS (overall survival) and PFS (progression-free survival) of our patients along with prognostic factors. PFS and OS were calculated using the Kaplan-Meier method. Prognostic factors were analyzed using Cox-Proportional Hazard model.

Results A total of 71 adult patients were diagnosed with PA at our institution between 1999 and 2017 (40 men and 31 women). During the median follow-up of 75.6 months, progression or recurrence of tumor occurred in 19 patients (26.8%). The extent of resection was strongly correlated to both PFS and OS (Kaplan Meier estimates, log-rank test, p<0.001) The overall survival rates at 5 year with APAs who achieved CR, PR and biopsy were 97%, 94% and 56%, respectively. And progression free survival rates at 5 year in CR, PR and biopsy patients were 91%, 63% and 32%, respectively.

Conclusion Adult PAs have more aggressive clinical behavior than pediatric PAs. Our study showed extent of resection (EOR); STR and biopsy, age of 40 or over and deep location were associated with poor prognostic factors for OS and PFS.