Journal of Korean Neurosurgical Society

  • 제53권5호
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  • Pages.281-287
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  • 2013
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Prognostic Factors and Therapeutic Outcomes in 22 Patients with Pleomorphic Xanthoastrocytoma

  • Lim, Sungryong (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jeong Hoon (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Sun A (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Eun Suk (Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Ra, Young Shin (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Chang Jin (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2012.11.13
  • 심사 : 2013.05.13
  • 발행 : 2013.05.28
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초록

Objective : Pleomorphic xanthoastrocytoma (PXA) is a rare primary low-grade astrocytic tumor classified as WHO II. It is generally benign, but disease progression and malignant transformation have been reported. Prognostic factors for PXA and optimal therapies are not well known. Methods : The study period was January 2000 to March 2012. Data on MR findings, histology, surgical extents and adjuvant therapies were reviewed in twenty-two patients diagnosed with PXA. Results : The frequent symptoms of PXA included seizures, headaches and neurologic deficits. Tumors were most common in the temporal lobe followed by frontal, parietal and occipital lobes. One patient who died from immediate post-operative complications was excluded from the statistical analysis. Of the remaining 21 patients, 3 (14%) died and 7 (33%) showed disease progression. Atypical tumor location (p<0.001), peritumoral edema (p=0.022) and large tumor size (p=0.048) were correlated with disease progression, however, Ki-67 index and necrosis were not statistically significant. Disease progression occurred in three (21%) of 14 patients who underwent GTR, compared with 4 (57%) of 7 patients who did not undergo GTR, however, it was not statistically significant. Ten patients received adjuvant radiotherapy and the tumors were controlled in 5 of these patients. Conclusion : The prognosis for PXA is good; in our patients overall survival was 84%, and event-free survival was 59% at 3 years. Atypical tumor location, peritumoral edema and large tumor size are significantly correlated with disease progression. GTR may provide prolonged disease control, and adjuvant radiotherapy may be beneficial, but further study is needed.

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참고문헌

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  4. Malignant Transformation of Cerebellar Pleomorphic Xanthoastrocytoma: A Case Report vol.7, pp.4, 2017, https://doi.org/10.4236/wjns.2017.74029
  5. Diagnostic accuracy of diffusion weighted imaging for differentiation of supratentorial pilocytic astrocytoma and pleomorphic xanthoastrocytoma vol.60, pp.7, 2018, https://doi.org/10.1007/s00234-018-2036-y
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