PRESENTATION AND OUTCOME OF METASTATIC LOW GRADE ASTROCYTOMA

Publication Type:

Journal Article

Source:

Neuro-Oncology, Volume 16, p.65-65 (2014)

URL:

http://scholars.fhcrc.org/4606/

Keywords:

2014, August 2014, Clinical Neurology, Oncology, Vaccine and Infectious Disease Division

Abstract:

{In rare cases, low grade astrocytoma (LGA) present with widespread leptomeningeal dissemination (LMD). Institutional studies report a wide range of 5-year overall survival (55% - 94%). We sought to consolidate our recent institutional experience with published cases to provide a comprehensive evaluation of LGA with LMD. PubMed and Google Scholar searches were performed to collect data from cases presented in medical literature (dated 1976–2013). Chart review of six cases diagnosed at Seattle Children’s Hospital (SCH) was also performed. Survival was analyzed from time of development of LMD using the Kaplan-Meier method. Association between survival and clinical factors of interest (gender, age, primary tumor site, histology, location of metastases, time of LMD development, year of diagnosis, extent of resection, treatment type) was evaluated by log rank test. 120 cases of LGA with LMD were identified including 6 contemporary cases from SCH. Histology was pilocytic astrocytoma (PA) in 56% of cases. 52% of patients with LMD were initially diagnosed with localized disease and then developed LMD a median of 23 months later (range 3 months to 23 years). Treatment regimens varied widely, including: chemotherapy and radiation (39%), chemotherapy only (25%), radiation only (20%) and observation only (16%). Three-year overall survival was 67.4%. Survival was not associated with age, gender, primary tumor site, location of metastases, extent of resection, or treatment type (p > 0.1). Survival tended to be higher (77%) for PA than other histologies (60%