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Journal of Korean Neurosurgical Society 2003;34(6): 514-520.
The Long-Term Survival in Patients with Anaplastic Astrocytoma or Glioblastoma.
Jin Woo Park, Jeong Hyun Hwang
Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea. jhwang@knu.ac.kr
The authors present an analysis of the long-term survivors with malignant glioma to find out their characteristics and the prognostic factors responsible for the long-term survival. METHODS: Forty two patients with histologically confirmed astrocytoma grade III or IV in adults(age> or =15) were included in this study. Medical records, radiological and histological findings were reviewed retrospectively. We compared the long-term survival group(LTSG, survival> or =5 years) with the group of patients who survived less than five years for the clinical, pathological, radiological factors and treatment modality. Additionally, survival analysis was performed to identify the prognostic factors for the whole patients with malignant glioma. RESULTS: Six of the 42 patients showed long-term survival(5-13 years) after diagnosis of anaplastic astrocytoma or glioblastoma. The mean age of LTSG was 41.8 years. We found histological dedifferentiation from low-to high-grade glioma in 4 cases. All of 6 patients were received aggressive multi-modality therapy including postoperative radiation and chemotherapy. Age(under 60 years), dedifferentiation and number of operation were significantly related to the LTSG. In multivariate analysis for the whole patients, we found that the age and postoperative radiotherapy were significant prognostic factors for malignant gliomas. CONCLUSION: The young age, prior history of low-grade glioma and repeated debulking surgeries are significantly associated with the long-term survival. Aggressive multidisciplinary approach is highly recommended in young patients with malignant glioma to increase the chance of long-term survival.
Key Words: Long-term survival; Glioblastoma; Anaplastic astrocytoma; Dedifferentiation
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