Surg-17. gross total resection outcomes in adult patients with brainstem glioma

Brainstem glioma (BSG) is much more rare and heterogeneous in adults compared to pediatric population. Clinical outcome of this type of brain tumor remains poor despite aggressive treatment. We analyzed 1667 patients of age 19 or older with the diagnosis of BSG identified from the NCI Surveillance, Epidemiology, and End Results database (1973-2012). Surgical treatment was categorized into no surgery, subtotal resection (STR), and gross total resection (GTR). Kaplan-Meier analysis and multivariate Cox proportional hazard modeling were used to assess the impact of treatment on overall survival (OS). 54.6% were males, and 83.1% were Caucasian. The median age was 45.5 years. Surgery was only performed in a small subset of patients with 7.4% receiving STR and 6.4% receiving GTR. OS at 10 years was 26.8%, with a median follow-up time of 9.7 years. Advanced age and high WHO grade were associated with poor OS, with 8.9% for age 75+ and 10.3% for grade IV at 10 years respectively. There was no significant OS benefit with RT for grade III (18.9% with RT vs. 18.4% without RT, p=0.94), but improved OS with RT for grade IV (12.1% with RT vs. 3.39% without RT, p=0.03). However, worse OS was observed with RT for grade I and grade II. Multivariate analysis adjusting for age, gender, year of diagnosis and WHO grade revealed improved OS associated with GTR (HR 0.574, 95% CI 0.412-0.777, p<0.01). The overall outcome of high-grade adult BSG remains poor though RT prov...
Source: Neuro-Oncology - Category: Cancer & Oncology Authors: Tags: SURGICAL THERAPY Source Type: research