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An Updated Comparison Between World Health Organization Grade II Gemistocytic and Diffuse Astrocytoma Survival and Treatment Patterns.
Rodrigues, Adrian; Zhang, Michael; Toland, Angus; Bhambhvani, Hriday; Hayden-Gephart, Melanie.
Afiliação
  • Rodrigues A; Department of Neurosurgery, Stanford School of Medicine, Stanford, California, USA.
  • Zhang M; Department of Neurosurgery, Stanford School of Medicine, Stanford, California, USA.
  • Toland A; Department of Pathology, Stanford School of Medicine, Stanford, California, USA.
  • Bhambhvani H; Department of Neurosurgery, Stanford School of Medicine, Stanford, California, USA.
  • Hayden-Gephart M; Department of Neurosurgery, Stanford School of Medicine, Stanford, California, USA. Electronic address: mghayden@stanford.edu.
World Neurosurg ; 158: e903-e913, 2022 02.
Article em En | MEDLINE | ID: mdl-34844008
BACKGROUND: In 2016, the World Health Organization revised its guidelines to retain only gemistocytic astrocytoma (GemA) as a distinct variant of diffuse astrocytoma (DA). In the past, grade II GemAs were linked with a worse prognosis than DA. However, it is unclear how consistently the tumor subtype has been diagnosed over time. We used more recent data to compare outcomes between grade II GemA and DA. METHODS: Patients with grade II DA and GemA were extracted from the Surveillance, Epidemiology, and End Results database between 1973 and 2016. Kaplan-Meier curves estimated survival differences across different eras, with a focus on patients diagnosed between 2000 and 2016, and propensity score matching was used to balance baseline characteristics between DA and GemA cohorts. RESULTS: Of 2467 patients with grade II astrocytoma diagnosed between 2000 and 2016, 132 (5.35%) had GemA, and 2335 (94.65%) had DA. At baseline, marked demographic and treatment differences were noted between tumor subtypes, including age at diagnosis and female sex. GemA patients did not have worse survival compared with DA patients at baseline (P = 0.349) or after propensity score matching (P = 0.497). Multivariate Cox models found that surgical extent of resection was associated with a survival benefit for DA patients, and both DA and GemA patients >65 years old had dramatically inferior survival. CONCLUSIONS: Our data suggest that the impact of GemA versus DA histopathology depends more on the decade of queried data rather than patient-specific demographics. Using more recent longitudinal data, we found that grade II GemA and DA tumors did not have significant differences in survival. These data may prove useful for clinicians counseling patients with grade II GemA.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Astrocitoma / Neoplasias Encefálicas Tipo de estudo: Guideline / Prognostic_studies Limite: Aged / Female / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Astrocitoma / Neoplasias Encefálicas Tipo de estudo: Guideline / Prognostic_studies Limite: Aged / Female / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article