Abstract
Objectives To investigate the surgical prognosis in adult patients with intracranial pilocytic astrocytoma (PA) and to analyze the related factors that affect its recurrence. Methods The treatment outcomes of 28 adult patients with PA reseted at the First Affiliated Hospital of Fujian Medical University from January 2006 to March 2013 were analyzed retrospectively. Among them, 19 had total tumor resection and 9 had partial tumor resection. Five patients received radiotherapy and/or chemotherapy after the first operation or reoperation. The prognoses of the patients were followed up and the possible factors for affecting tumor recurrence were investigated. Kaplan-Meier analysis was used to analyze the postoperative progression-free survival rate of the patients. Results Twenty-eight patients were followed up for 8 to 92 months after procedure (mean 41.2 months). There were no deaths during the follow-up period. Kaplan-Meier results showed that the progression free survival at 24 months after initial surgery was 92.7±5.0%. A total of 7 patients had recurrence; the mean recurrence time was 49.5 months (range, 4 to 60 months). In the 7 patients, the tumors of 4 patients were located in the supratentorial region, and 4 needed to be reoperated because of disease progression. The pathological diagnosis of 1 patient was anaplastic astrocytoma after the second operation. The tumors did not recur or enlarge in 5 patients who received radiotherapy and/or chemotherapy. The proportions of recurrence of the total resection and subtotal resection were 1/19 and 6/9 respectively. There was significant difference (P 0.05). Conclusions The postoperative prognosis is better in adult patients with intracranial PA. The total resection may be one of the factors for avoiding tumor recurrence. The tumors of patients failed to be totally resected should pay attention to the faster tumor recurrence. The recurrent cases may have malignant transformation, and the postoperative follow-up of these adult patients should be strengthened. Key words: Pilocytic astrocytoma; Adult; Recurrence; Prognosis
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