Talia Wegman-Ostrosky1, Nancy Reynoso-Noverón2, Sonia I Mejía-Pérez3, Thalía E Sánchez-Correa4, Rosa María Alvarez-Gómez5, Silvia Vidal-Millán6, Bernardo Cacho-Díaz7, José Sánchez-Corona8, Luis A Herrera-Montalvo9, Teresa Corona-Vázquez10. 1. Dirección de Investigación, Instituto Nacional de Cancerologia, San Fernando 22, Sección XVI, CP 14080 Tlalpan, CDMX, Mexico. Electronic address: taliaw@gmail.com. 2. Dirección de Investigación, Instituto Nacional de Cancerologia, San Fernando 22, Sección XVI, CP 14080 Tlalpan, CDMX, Mexico. Electronic address: nrn231002@yahoo.com.mx. 3. Subdirección de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía, Insurgentes Sur # 3877, CP 14269 Tlalpan, CDMX, Mexico. Electronic address: soniamejia@neurocirugia-innn.com. 4. Subdirección de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía, Insurgentes Sur # 3877, CP 14269 Tlalpan, CDMX, Mexico. Electronic address: thaesa@gmail.com. 5. Dirección de Investigación, Instituto Nacional de Cancerologia, San Fernando 22, Sección XVI, CP 14080 Tlalpan, CDMX, Mexico. Electronic address: rosamag2@hotmail.com. 6. Dirección de Investigación, Instituto Nacional de Cancerologia, San Fernando 22, Sección XVI, CP 14080 Tlalpan, CDMX, Mexico. Electronic address: vidals02@yahoo.com. 7. Departamento Neuro-oncologia, Instituto Nacional de Cancerologia San Fernando 22, Sección XVI, CP 14080 Tlalpan, CDMX, Mexico. Electronic address: bernardocacho@doctor.com. 8. Dirección Centro de Investigaciones Biomedicas, Cetro Médico de Occidente, IMSS, Sierra mojada 800, 44340 Guadalajara, Jalisco, Mexico. Electronic address: josancomx@yahoo.com.mx. 9. Dirección de Investigación, Instituto Nacional de Cancerologia, San Fernando 22, Sección XVI, CP 14080 Tlalpan, CDMX, Mexico. Electronic address: herreram@biomedicas.unam.mx. 10. Laboratorio Clínico de Enfermedades Neurodegenerativas, Instituto Nacional de Neurología y Neurocirugía, Insurgentes Sur # 3877, CP 14269 Tlalpan, CDMX, Mexico. Electronic address: coronav@unam.mx.
Abstract
OBJECTIVE: To explore the clinical prognostic factors for adults affected with astrocytoma. PATIENTS AND METHODS: Using a historic cohort, we selected 155 clinical files from patients with astrocytoma using simple randomization. The main outcome variable was overall survival time. To identify clinical prognostic factors, we used bivariate analysis, Kaplan Meier, the log rank test and the Cox regression models. The number of lost years lived with disability (DALY) based on prevalence, was calculated. RESULTS: The mean age at diagnosis was 45.7 years. Analysis according to tumour stage, including grades II, III and IV, also showed a younger age of presentation. Kaplan-Meier survival estimates showed that tumour grade, Karnofsky status (KPS) ≥70, resection type, chemotherapy, radiotherapy, alcohol consumption, familial history of cancer and clinical presentation were significantly associated with survival time. Using a proportional hazard model, age, grade IV, resection, chemotherapy+radiotherapy and KPS were identified as prognostic factors.The amount of life lost due to premature death in this population was 28 years. CONCLUSION: In our study, astrocytoma was diagnosed in young adults. The overall survival was 15 months, 9% (n=14) of patients presented a survival of 2 years, and 3% of patients survived 3 years. On average the number of years lost due to premature death and disability was 28.53 years.
OBJECTIVE: To explore the clinical prognostic factors for adults affected with astrocytoma. PATIENTS AND METHODS: Using a historic cohort, we selected 155 clinical files from patients with astrocytoma using simple randomization. The main outcome variable was overall survival time. To identify clinical prognostic factors, we used bivariate analysis, Kaplan Meier, the log rank test and the Cox regression models. The number of lost years lived with disability (DALY) based on prevalence, was calculated. RESULTS: The mean age at diagnosis was 45.7 years. Analysis according to tumour stage, including grades II, III and IV, also showed a younger age of presentation. Kaplan-Meier survival estimates showed that tumour grade, Karnofsky status (KPS) ≥70, resection type, chemotherapy, radiotherapy, alcohol consumption, familial history of cancer and clinical presentation were significantly associated with survival time. Using a proportional hazard model, age, grade IV, resection, chemotherapy+radiotherapy and KPS were identified as prognostic factors.The amount of life lost due to premature death in this population was 28 years. CONCLUSION: In our study, astrocytoma was diagnosed in young adults. The overall survival was 15 months, 9% (n=14) of patients presented a survival of 2 years, and 3% of patients survived 3 years. On average the number of years lost due to premature death and disability was 28.53 years.
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