Five-year follow-up results for patients diagnosed with anaplastic astrocytoma and effectiveness of concomitant therapy with temozolomide for recurrent anaplastic astrocytoma

BACKGROUND: Anaplastic astrocytoma (AA; WHO grade-III) patients determination of prognostic factors helps generating multimodal therapy protocols. For this purpose, in the Baskent University, Adana Medical Research Center, specific characteristics of AA patients who have surgery were retrospectively investigated and factors which affect prognosis has been determined. PATIENTS AND METHODS: Between January 2005 and 2009, 20 patients who have AA have been evaluated retrospectively. Totally, 20 patients had 31 operations. Sixteen patients had only adjuvant radiation therapy (RT). In the postoperative period, 8 patients received adjuvant RT. Nine of 10 patients with tumor recurrence received concomitant therapy with temozolomide (ConcT with TMZ) protocol. No adjuvant therapy protocol could be applied in three patients with poor general condition in the postoperative period. RESULTS: Median survival for patients died was 16±17 months; one year survival was 75% and five year survival 25%. After univariate analysis, preoperative Karnofsky performance score (KPS) was ≥80 (P=0.005577(*)), postoperative KPS was ≥80 (P=0.003825(*)), type of tumor resection (P=0.001751(*)), multiple operations (P=0.006233(*)), and ConcT with TMZ protocol (P=0,005766(*)) were all positive prognostic factors which extend the survival. CONCLUSIONS: The results of the multivariate analysis did not put forward an independent prognostic factor acting on the survival period (P>0.05).