Treatment Outcomes and Prognostic Factors in Adult Astrocytoma: In North East of Iran

Background: Astrocytomas are the most common primary adult brain tumors. Objectives: In this study, we investigated the impact of some potential prognostic factors on survival in patients with low and high grade astrocytomas. Patients and Methods: This retrospective cohort study was performed on patients with brain astrocytoma who were referred to oncology departments, Omid and Ghaem hospitals, Mashhad University of Medical Sciences (2000 - 2011). Results: 415 patients with a median age of 43 and a male to female ratio of 252:163 (1.54) were recorded. Grade I to IV astrocytoma were found in 40 (9.6%), 88 (21.2%), 71 (17.1%) and 216 (52%) patients. With a median follow up time of 37 months for low grade and 13 months for high grade astrocytoma, the 5-year survival in grades I to IV was 92.1%, 69.1%, 49.2% and 9.6% respectively. In low grade astrocytomas, patients with grade I tumors, being ambulatory (5-year survival: 88% vs. 60.3%, P < 0.001) and performing optimal surgery (5-year survival 86% vs. 59.3%, P < 0.001) were associated with more favorable survival. In high grade astrocytomas, patients with grade III tumors, age < 50 (5-year survival 29.6% vs. 14.6%, P < 0.001), being ambulatory (5-year survival 39.4% vs. 10.5, P < 0.001), performing optimal surgery (5-year survival 46.1% vs. 4.3%, P < 0.001) and receiving chemotherapy (5-year survival 23.7% vs. 18.7%, P = 0.02) were associated with significantly higher overall survival. Conclusions: Performing optimal surgery and good performance status were associated with more favorable survival in both low and high grade astrocytomas. In high grade a strocytomas, patients younger than 43 and those who received chemotherapy had better overall survival.