Prognostic factors in adult brainstem gliomas: a multicenter, retrospective analysis of 101 cases
Prognostic factors in adult brainstem gliomas: a multicenter, retrospective analysis of 101 cases
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DOI：
10.1007/s11060-008-9545-1
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发表时间：
2008-06-01
影响因子：
3.9
通讯作者：
Pruitt, Amy A.
中科院分区：
文献类型：
--
作者：
Kesari, Santosh;Kim, Ryung S.;Pruitt, Amy A.
背景 成人脑干胶质瘤（BSG）并不常见，而且对其预后因素知之甚少。我们回顾性评估了 101 名推测患有 BSG 或活检证实患有 BSG 的成年人的临床、放射学、组织学和治疗特征，以确定预后因素。患者和方法 我们回顾了 1987 年至 2005 年诊断的患者记录。我们使用 Cox 比例风险模型来确定预后因素。结果这 50 名男性和 51 名女性患者诊断时年龄为 18 至 79 岁（中位 36 岁），随访时间为 1 至 261 个月（中位 47 个月）。所有患者 5 年和 10 年的总生存率分别为 58% 和 41%，中位生存期为 85 个月（范围 1-228）。在 24 个候选预后因素中，我们通过 Lasso 程序选择了 7 个协变量用于比例风险模型：诊断年龄、种族、皮质类固醇需求、肿瘤分级、吞咽困难、肿瘤位置和卡诺夫斯基体能状态 (KPS)。单变量分析显示这七个因素与生存显着相关。多变量分析显示，四个协变量显着增加了生存风险：种族、肿瘤位置、诊断年龄和肿瘤分级。结论 在这项研究中，我们确定了四个与 BSG 成人生存显着相关的预后因素。总体而言，这些患者的预后比文献报道的患有 BSG 的儿童更好。这些结果需要进行更大规模的前瞻性研究，以充分评估这些因素在临床环境中的重要性，并帮助在未来的临床研究中对患者进行分层。
Background Adult brainstem gliomas (BSG) are uncommon and poorly understood with respect to prognostic factors. We retrospectively evaluated the clinical, radiographic, histologic, and treatment features from 101 adults with presumed or biopsy proven BSG to determine prognostic factors. Patients and Methods We reviewed the records of patients diagnosed from 1987-2005. We used Cox proportional hazard models to determine prognostic factors. Results These 50 male and 51 female patients ranged in age from 18 to 79 years at diagnosis (median 36 years) with follow-ups from I to 261 months (median 47 months). The overall survival for all patients at 5 and 10 years was 58% and 41%, respectively, with a median survival of 85 months (range 1-228). Out of 24 candidate prognosis factors, we selected seven covariates for proportional hazards model by Lasso procedure: age of diagnosis, ethnicity, need for corticosteroids, tumor grade, dysphagia, tumor location, and karnofsky performance status (KPS). Univariate analysis showed that these seven factors are significantly associated with survival. Multivariate analysis showed that four covariates significantly increased hazard for survival: ethnicity, tumor location, age of diagnosis, and tumor grade. Conclusions In this study, we identified four prognostic factors that were significantly associated with survival in adults with BSGs. Overall, these patients have a better prognosis than children with BSGs reported in the literature. These results call for larger prospective studies to fully assess the importance of these factors in the clinical setting and to help stratify patients in future clinical studies.