Prognostic factors in adult brainstem gliomas

A multicenter, retrospective analysis of 101 cases

Santosh Kesari, Ryung S. Kim, Vassilios Markos, Jan Drappatz, Patrick Y. Wen, Amy A. Pruitt

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

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 1 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.

Original languageEnglish (US)
Pages (from-to)175-183
Number of pages9
JournalJournal of Neuro-Oncology
Volume88
Issue number2
DOIs
StatePublished - Jun 2008
Externally publishedYes

Fingerprint

Glioma
Brain Stem
Survival
Proportional Hazards Models
Neoplasms
Karnofsky Performance Status
Deglutition Disorders
Adrenal Cortex Hormones
Multivariate Analysis
Prospective Studies
Biopsy

Keywords

  • Brainstem glioma
  • Chemotherapy
  • Natural history
  • Prognostic factors
  • Radiation
  • Surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neuroscience(all)

Cite this

Prognostic factors in adult brainstem gliomas : A multicenter, retrospective analysis of 101 cases. / Kesari, Santosh; Kim, Ryung S.; Markos, Vassilios; Drappatz, Jan; Wen, Patrick Y.; Pruitt, Amy A.

In: Journal of Neuro-Oncology, Vol. 88, No. 2, 06.2008, p. 175-183.

Research output: Contribution to journalArticle

Kesari, Santosh ; Kim, Ryung S. ; Markos, Vassilios ; Drappatz, Jan ; Wen, Patrick Y. ; Pruitt, Amy A. / Prognostic factors in adult brainstem gliomas : A multicenter, retrospective analysis of 101 cases. In: Journal of Neuro-Oncology. 2008 ; Vol. 88, No. 2. pp. 175-183.
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