Intramedullary Astrocytoma – a Series of 15 Patients and Literature Overview

Summary

Intramedullary astrocytoma is one of the less common tumours of the central nervous system. Certain ambiguities in the literature led us to make a retrospective review of a series of our own (2003–2009) and to compare the results with available literature. This series comprised 15 patients (10 women, 5 men), mean age 42.6 years. According to the McCormick scale, 5 patients were class I, 4 class II, 1 class III and 5 class IV. No tumour was radically resected, while 11 patients underwent subtotal resection, 4 only bio­psy. Morbidity/mortality was 20% (1 dead and 2 patients deteriorating on the McCormick scale). Thirteen tumours were classified as low‑grade, 1 as grade III and one as glioblastoma. During the follow‑up period (mean 29.3 months) 5 patients died, 4 due to tumour progression. Median overall survival was estimated at 35.8 months. Younger age (p = 0.03), male sex (p = 0.04) and the presence of tumour cyst (p = 0.01) were identified as positive prognostic factors influencing overall survival. Other prognostic factors from the literature are discussed and treatment recommendations are made on the basis of its reviewing.

Key words:
intramedullary tumor – astrocytoma – survival – prognostic factors – literature review