Jared Sullivan, James P. Chandler, Maciej S. Lesniak, Matthew C. Tate, A. Sonabend, John A Kalapurakal, Craig Horbinski, R. Lukas, Priya Kumthekar, S. Sachdev
{"title":"Clinical outcomes for pleomorphic xanthoastrocytoma patients","authors":"Jared Sullivan, James P. Chandler, Maciej S. Lesniak, Matthew C. Tate, A. Sonabend, John A Kalapurakal, Craig Horbinski, R. Lukas, Priya Kumthekar, S. Sachdev","doi":"10.1093/nop/npae074","DOIUrl":null,"url":null,"abstract":"\n \n \n Report our institutional experience with pleomorphic xanthoastrocytoma (PXA) to contribute to limited data on optimal management.\n \n \n \n Patients with pathologically confirmed PXA treated at our institution between 1990 and 2019 were identified. Demographic information, tumor grade, treatment variables, and clinical outcomes were collected from patient charts. Kaplan-Meier estimates were used to summarize two primary outcome measurements: progression-free survival (PFS) and overall survival (OS). Outcomes were stratified by tumor grade and extent of resection. Cox regression and log-rank testing were performed.\n \n \n \n We identified 17 patients with pathologically confirmed PXA. Two patients were excluded due to incomplete treatment information or <6m of follow-up; 15 patients were analyzed (median follow-up 4.4y). Six patients had grade 2 PXA and 9 had grade 3 anaplastic PXA. The 2-year and 5-year PFS for the cohort was 57% and 33%, respectively; 2-year and 5-year OS was 93% and 75%, respectively. Patients with grade 2 tumors exhibited superior PFS compared to those with grade 3 tumors (2-year PFS: 100% vs. 28%, 5-year PFS: 60% vs. 14%), hazard ratio, 5.09 (95% CI: 1.06-24.50), p = 0.02. Undergoing a GTR was associated with numerical longer survival but this was not of statistical significance (hazard ratio: 0.38, p = 0.15). All but one (89%) of the grade 3 patients underwent RT.\n \n \n \n The poor survival of the cohort, especially with grade 3 tumors, suggests the need for more aggressive treatment, including maximal resection followed by intensive adjuvant therapy. Better prognostics of tumor recurrence are needed to guide the use of adjuvant therapy.\n","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":"23 4","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/nop/npae074","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}
引用次数: 0
Abstract
Report our institutional experience with pleomorphic xanthoastrocytoma (PXA) to contribute to limited data on optimal management.
Patients with pathologically confirmed PXA treated at our institution between 1990 and 2019 were identified. Demographic information, tumor grade, treatment variables, and clinical outcomes were collected from patient charts. Kaplan-Meier estimates were used to summarize two primary outcome measurements: progression-free survival (PFS) and overall survival (OS). Outcomes were stratified by tumor grade and extent of resection. Cox regression and log-rank testing were performed.
We identified 17 patients with pathologically confirmed PXA. Two patients were excluded due to incomplete treatment information or <6m of follow-up; 15 patients were analyzed (median follow-up 4.4y). Six patients had grade 2 PXA and 9 had grade 3 anaplastic PXA. The 2-year and 5-year PFS for the cohort was 57% and 33%, respectively; 2-year and 5-year OS was 93% and 75%, respectively. Patients with grade 2 tumors exhibited superior PFS compared to those with grade 3 tumors (2-year PFS: 100% vs. 28%, 5-year PFS: 60% vs. 14%), hazard ratio, 5.09 (95% CI: 1.06-24.50), p = 0.02. Undergoing a GTR was associated with numerical longer survival but this was not of statistical significance (hazard ratio: 0.38, p = 0.15). All but one (89%) of the grade 3 patients underwent RT.
The poor survival of the cohort, especially with grade 3 tumors, suggests the need for more aggressive treatment, including maximal resection followed by intensive adjuvant therapy. Better prognostics of tumor recurrence are needed to guide the use of adjuvant therapy.
期刊介绍:
ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications.
The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.