Gabriela Boschetti1, Adrialdo Jose Santos2, Kellen Paiva Fermon2, Gustavo Lopes de Freitas Honório2, Gabriel Batistella2, Solena Ziemer Kusma3, João Norberto Stávale4, Manoel Antonio de Paiva Neto2, Suzana Maria Fleury Malheiros5. 1. Department of Neurosurgery, Neuro-oncology Service, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; School of Medicine Deparment, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil; Medical School Department, Faculdades Pequeno Príncipe, Curitiba, Paraná, Brazil. Electronic address: gabiboschetti@hotmail.com. 2. Department of Neurosurgery, Neuro-oncology Service, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil. 3. School of Medicine Deparment, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil; Department of Public Health, Universidade Federal do Paraná, Curitiba, Paraná, Brazil. 4. Department of Pathology, Neuropathology Service, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Department of Pathology, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil. 5. Department of Neurosurgery, Neuro-oncology Service, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Department of Oncology, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
Abstract
OBJECTIVE: Pilocytic astrocytoma (PA) is rare in adults comprising 5.1% of the primary central nervous system tumors. The aim is to describe the first Brazilian series of adult patients with PA and compare its features with the available literature. METHODS: We retrospectively review all patients 18 years or older with PA from our institution's database from 1991 to 2018. We analyzed information regarding clinical presentation, location, imaging features, extent of resection, adjuvant treatments, and follow-up. RESULTS: Twenty-three patients with PA were analyzed: 60.9% male; median age 26 years. The most frequent symptoms were headache (34.8%) and seizure (26.1%). Temporal and parietal lobes were the most common locations, 21.7% each. All patients underwent a surgical procedure, gross total resection in 40.9%, subtotal resection in 22.7%, and biopsy in 27.3%. Adjuvant treatment with radiotherapy was performed in 2 patients. Only 4 patients had disease progression, 2 after gross total resection and 2 after subtotal resection. They were all alive and without evidence of new progression at the last follow-up (October 2018). Median overall survival was not reached after a median follow-up time of 88.9 months. CONCLUSIONS: This is the first Brazilian series regarding adults with PA, and our patients had a favorable outcome as reported in recent literature reviews. The tumor's prevalence reduces within older patients and supratentorial lesions are more frequent, especially on the temporal lobe. There was no significant relationship between location and progression, although according to the literature the extent of resection remains the most important prognostic factor.
OBJECTIVE: Pilocytic astrocytoma (PA) is rare in adults comprising 5.1% of the primary central nervous system tumors. The aim is to describe the first Brazilian series of adult patients with PA and compare its features with the available literature. METHODS: We retrospectively review all patients 18 years or older with PA from our institution's database from 1991 to 2018. We analyzed information regarding clinical presentation, location, imaging features, extent of resection, adjuvant treatments, and follow-up. RESULTS: Twenty-three patients with PA were analyzed: 60.9% male; median age 26 years. The most frequent symptoms were headache (34.8%) and seizure (26.1%). Temporal and parietal lobes were the most common locations, 21.7% each. All patients underwent a surgical procedure, gross total resection in 40.9%, subtotal resection in 22.7%, and biopsy in 27.3%. Adjuvant treatment with radiotherapy was performed in 2 patients. Only 4 patients had disease progression, 2 after gross total resection and 2 after subtotal resection. They were all alive and without evidence of new progression at the last follow-up (October 2018). Median overall survival was not reached after a median follow-up time of 88.9 months. CONCLUSIONS: This is the first Brazilian series regarding adults with PA, and our patients had a favorable outcome as reported in recent literature reviews. The tumor's prevalence reduces within older patients and supratentorial lesions are more frequent, especially on the temporal lobe. There was no significant relationship between location and progression, although according to the literature the extent of resection remains the most important prognostic factor.
Authors: Jacopo Falco; Julius Höhne; Morgan Broggi; Emanuele Rubiu; Francesco Restelli; Ignazio G Vetrano; Marco Schiariti; Elio Mazzapicchi; Giulio Bonomo; Paolo Ferroli; Karl-Michael Schebesch; Francesco Acerbi Journal: Front Oncol Date: 2022-08-09 Impact factor: 5.738