Cerebellar astrocytoma: experience with 54 cases surgically treated at the Mayo Clinic, Rochester, Minnesota, from 1978 to 1990

Abstract

A comprehensive review of the literature has shown that the treatment of choice for cerebellar astrocytomas has primarily been gross-total resection of the mass and gross-total resection of the enhancing portion of pilocytic astrocytomas. Most large scale studies of postresection survival rates of patients with cerebellar astrocytomas were conducted when computerized tomography (CT) and magnetic resonance (MR) imaging were not readily available. It has been shown that postoperative CT scans or MR images are more reliable than the surgeon's estimate of the degree of tumor resection at the time of surgery. It is not possible, therefore, to make an accurate determination regarding a postresection prognosis based on the degree of suspected tumor resection without the availability of appropriate radiographic imaging. In this study, the authors retrospectively evaluated the treatment of 54 patients with cerebellar astrocytoma who underwent surgery at the Mayo Clinic in Rochester, Minnesota, from 1978 through 1990. Preoperative and postoperative CT scans or MR images were available in all 54 patients.

Pilocytic Astrocytomas in Children: Prognostic Factors—A Retrospective Study of 80 Cases

“…In our series, the degree and/or quality of resection were major prognostic factors for the whole group (P Ͻ 0.001). Total resection led to 5-and 10-year survival rates of 100% (12,18) and recurrence rates of 2 to 5.4%, whereas 42 to 45% of partially removed PAs have been demonstrated to recur (e.g., 20 cases in the present series). The efficacy of chemo-and radiotherapy in these cases is a topic of debate (9,19), but these treatment modalities seem to be useful in stabilizing inoperable or multicentric PAs (2,4,14,20).…”

Prognostic Factors for Cerebellar Astrocytomas in Children: A Study of 102 Cases

“…The length of survival has been documented to be directly dependent on the histological grading of the tumor [12, 13, 14, 15, 16, 17, 18]. The length of survival is good with PA and LGFA.…”

“…It is an important positive factor in relation to recurrence and the patient’s survival [2, 3, 6, 10, 11, 13, 23, 24]. Despite this, some authors still contend that a complete resection is not essential, citing several cases in which there was no tumor recurrence for several years after partial removal [25, 26, 27, 28].…”

A population-based study of the incidence and survival rates in patients with pilocytic astrocytoma

“…Forsyth, et al, 13 analyzed 51 supratentorial pilocytic astrocytomas diagnosed in the same calendar period and based on the same registry and found that survival rates for 10 and 20 years were 82%. Morreale, et al, 19 reported on 54 cerebellar astrocytomas treated at the Mayo Clinic in Rochester, Minnesota, between 1978 and 1990. Of these, 39 (72%) were pilocytic astrocytomas.…”