Oh Taemin, Kaur Gurvinder, Madden Michelle, Bloch Orin, Parsa Andrew T
Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair St, Suite 2210, Chicago, IL 60611-2911, USA.
Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA; Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair St, Suite 2210, Chicago, IL 60611-2911, USA.
J Clin Neurosci. 2014 Oct;21(10):1767-72. doi: 10.1016/j.jocn.2014.04.002. Epub 2014 Jun 17.
Pleomorphic xanthoastrocytoma (PXA) is a rare, low-grade glioma (World Health Organization Grade II) that most often presents in the first two decades of life. We summarize and present our institutional experience in the management of these tumors. All patients managed for PXA at the University of California San Francisco were retrospectively identified through chart review. Patient demographics, tumor characteristics, management, and follow-up were extracted using medical records. Primary endpoints were overall (OS) and progression-free survival (PFS). In total, nineteen patients were treated for PXA from 1993-2011. Clinical data were available for analysis in 18 patients. Median OS was 209.0 months after date of surgery, with both 5 year and 10 year survival rates of 94%. In this patient cohort, tumor grade (p=0.07), age (p=0.32), and extent of resection (p=0.58) did not predict OS. The majority of tumors (78%) recurred. Median PFS was 21.7 months, with 5 year and 10 year recurrence-free rates of 28% and 22%. On univariate analysis, tumor grade (p=0.01), but not age (p=0.51), size (p=0.30), or extent of resection (p=0.21), was the only covariate predictive of PFS. In patients presenting with higher tumor grade, however, earlier recurrence was demonstrated. Furthermore, the majority of recurrences (36%) occurred within the first 6 months post-operatively, which indicates the need to closely follow patients for that time.
多形性黄色星形细胞瘤（PXA）是一种罕见的低级别胶质瘤（世界卫生组织二级），最常出现在生命的前二十年。我们总结并介绍了我们机构在这些肿瘤管理方面的经验。通过病历回顾，对加利福尼亚大学旧金山分校所有接受PXA治疗的患者进行了回顾性识别。使用病历提取患者人口统计学、肿瘤特征、管理和随访信息。主要终点是总生存期（OS）和无进展生存期（PFS）。1993年至2011年期间，共有19例患者接受了PXA治疗。18例患者有可供分析的临床数据。手术后中位总生存期为209.0个月，5年和10年生存率均为94%。在这个患者队列中，肿瘤分级（p = 0.07）、年龄（p = 0.32）和切除范围（p = 0.58）均不能预测总生存期。大多数肿瘤（78%）复发。中位无进展生存期为21.7个月，5年和10年无复发生存率分别为28%和22%。单因素分析显示，肿瘤分级（p = 0.01）是唯一预测无进展生存期的协变量，而年龄（p = 0.51）、大小（p = 0.30）或切除范围（p = 0.21）则不是。然而，在肿瘤分级较高的患者中，复发更早。此外，大多数复发（36%）发生在术后前6个月内，这表明在此期间需要密切随访患者。
