Long Term Results of Adult Spinal Cord Astrocytoma.

Kim, Myoung Soo; Chung, Chun Kee; Kim, Hyun Jib; Kim, Sam Soo; Choe, Gheeyoung; Chi, Je G

Original Article

Journal of Korean Neurosurgical Society 2002;31(3): 234-240.

Myoung Soo Kim, Chun Kee Chung, Hyun Jib Kim, Sam Soo Kim, Gheeyoung Choe, Je G Chi

¹Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
²Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
³Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

OBJECTIVE
To provide the better treatment guideline for spinal cord astrocytomas, the authors present a retrospective analysis of our series.
METHODS
We managed 28 patients(mean age 36 years) in our institute from 1978 through 1999. Nineteen patients received radiation therapy after biopsy or resection. Gross total removal was performed in three cases. The median follow-up period was 6.5 months(range, 0.5-184 months).
RESULTS
Low-grade astrocytomas were found in 18 cases, anaplastic astrocytoma in three cases and glioblastomas in seven cases. The cumulative survival of patients with low grade astrocytoma was 62.3% at 8.5 years and the cumulative survival of patients with high grade glioma was 19.1% at 11 months (p=0.0017). The overall survival of irradiated patients with low grade astrocytoma was 88% at six months, and the overall survival of non-irradiated patients with low grade astrocytoma was 60% at eight months(p=0.0565). Neither the extent of resection, nor the location of tumor influenced the survival rate (p=0.468 and p=0.8632, respectively).
CONCLUSION
Histological grade was the most significant predictor of survival in patients with astrocytoma of the spinal cord. Postoperative radiation therapy in low-grade astrocytomas tended to improve the survival rate.

Key Words: Astrocytoma; Spinal cord; Survival; Radiation