Clinical features of adult pilocytic astrocytoma

Bie Pengfei; Yan Xiaoling; Tang Fan; Zhang Xuebin; Huang Ying

doi:10.11850/j.issn.1009-122X.2017.06.006

Abstract：Objective To analyze the clinical features of adult pilocytic astrocytoma (PA).Methods Clinical data of 74 patients with adult PA were analyzed retrospectively.The tumors were located in supratentorial lobe in 46 patients (62.2％),in infratentorial lobe in 23 (31.1％) and in intramedullary spinal cord in 5 (6.8％).The major clinical symptoms were the corresponding symptoms caused by intracranial hypertension.Microsurgery of tumor resection was performed in 73 patients and biopsy (without surgical treatment) in 1.Results Total tumor resection was achieved in 43 patients and subtotal resection in 30,while hydrocephalus occurred in 3 patients after the operation.The expressions of glial fibrillary acidic protein (GFAP),S-100 and vimentin were positive,while the mean positive expression index of Ki-67 was 2.8％ ± 2.9％,ranged from 0 to 18％ according to the immunohistochemistry staining.During a mean follow-up period of 6.7 ± 4.6 years,8 patients were lost to follow-up,progression-free survival was obtained in 51 patients,progression survival in 8 and died in 7.Forty-three patients were followed up for more than 5 years,5 patients died,progression-free survival was obtained in 32 patients and progression survival in 6.The five-year overall survival rate was 88.4％ and progression-free survival rate was 74.4％.Conclusions The incidence of adult PA is not rare,and has a predilection for the supratentorial lobe,especially for the temporal lobe.The tumor cell proliferation is active in adult PA,and has a potential to become malignant,so,postoperative radiotherapy should be performed for patients with tumor residual as soon as possible.