Predicting survival in anaplastic astrocytoma patients in a single-center cohort of 108 patients

Abstract

Background Current guidelines for the treatment of anaplastic astrocytoma (AA) recommend maximal safe resection followed by radiotherapy and chemotherapy. Despite this multimodal treatment approach, patients have a limited life expectancy. In the present study, we identified variables associated with overall survival (OS) and constructed a model score to predict the OS of patients with AA at the time of their primary diagnosis. Methods We retrospectively evaluated 108 patients with newly diagnosed AA. The patient and tumor characteristics were analyzed for their impact on OS. Variables significantly associated with OS on multivariable analysis were included in our score. The final algorithm was based on the 36-month survival rates corresponding to each characteristic. Results On univariate analysis, age, Karnofsky performance status, isocitrate dehydrogenase status, and extent of resection were significantly associated with OS. On multivariable analysis all four variables remained significant and were consequently incorporated in the score. The total score ranges from 20 to 33 points. We designated three prognostic groups: A (20–25), B (26–29), and C (30–33 points) with 36-month OS rates of 23%, 71%, and 100%, respectively. The OS rate at 5 years was 8% in group A, 61% in group B and 88% in group C. Conclusions Our model score predicts the OS of patients newly diagnosed with AA and distinguishes patients with a poor survival prognosis from those with a greater life expectancy. Independent and prospective validation is needed. The upcoming changes of the WHO classification of brain tumors as well as the practice changing results from the CATNON trial will most likely require adaption of the score.

Radiation Therapy for Grade 3 Gliomas: Correlation of MRI Findings With Prognosis

“…Of particular note, the significance of 1p/19q codeletion [17][18][19] and mutation of isocitrate dehydrogenase 1 or 2 (IDH1-mt or IDH2-mt) [17,[19][20][21] has recently been established with regard to the prediction of the prognosis of gliomas. Some recent reports indicate that 1p/19q codeletion and MGMT are significantly associated with OS and PFS even in an analysis targeting only grade 3 gliomas [22][23][24].…”

Mutant IDH in Gliomas: Role in Cancer and Treatment Options

“…The presence of IDH mutation confers survival advantage to patients diagnosed with grade III or IV gliomas and so acts as a unique target for immune therapy [170] [171]. The trial comprised 8 vaccinations in total and 90.6% of participants experienced non-severe adverse effects.…”

Mutant IDH in Gliomas: Role in Cancer and Treatment Options

“…Alongside HR there is another pathway of DNA repair with relies on the poly(ADP-ribose) polymerase (PARP) family of enzymes. PARP enzymes play a role in the repair of single-strand breaks where they perform base-excision and nucleotide-excision repair [183]. Interestingly, when the HR pathway is inhibited in mutant IDH1 cell lines due to the D2-HG accumulation, PARP enzymes become a point of failure in the system.…”