Clinical characteristics and long-term surgical outcomes of spinal pilocytic astrocytoma: a report of twenty cases
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ORIGINAL ARTICLE - TUMOR - GLIOMA
Clinical characteristics and long-term surgical outcomes of spinal pilocytic astrocytoma: a report of twenty cases Liang Zhang 1,2 & Teng Li 2 & Guangyu Qiao 2 & Wuyang Yang 3 & Aijia Shang 2 & Xinguang Yu 1,2 Received: 4 August 2020 / Accepted: 2 October 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Background Primary spinal pilocytic astrocytoma (PA) is an extremely rare low-grade astrocytoma with unclear natural history. The demographic characteristics, imaging features, and long-term surgical outcomes have not been clarified due to low prevalence and limited reports. Methods A retrospective review within a single institution between 2004 and 2018 of all patients with pathologically proven PA was conducted. Patient data including demographics, radiographic features, treatment modalities, and long-term outcomes were evaluated. Results Twenty consecutive patients were identified, and 16 (80%) were male patients, with a mean age at presentation of 29 ± 13 years. The lesion was primarily located in cervical (n = 10, 50%), thoracic (n = 7, 35%), cervico-thoracic junction (n = 2), and lumbar level (n = 1, 5%). The tumor had a mean extension of 4 ± 2 (1–7) vertebral segments. Most PAs were located eccentrically (n = 16, 80%), with most being heterogeneous in appearance (cystic and solid) or purely cystic (n = 14, 70%), and had unclear margins (n = 16, 80%). Eleven patients (55%) had associated syringomyelia. Gross total resection (GTR) was achieved in 11 (55%) patients, and subtotal resection (STR) in 9 (45%). During a mean follow-up of 104 ± 56 months, 2 patients died and recurrence was found in 4 patients (20%), translating to a mean progression-free survival of 21 ± 11 months. Conclusion Primary spinal PA is a rare entity with acceptable progression-free survival if treated appropriately. Surgical resection may provide reasonable prolongation of survival, and GTR should be achieved if possible. A close follow-up is recommended especially for residual lesions, and a further in-depth investigation of molecular biomarkers is needed to stratify risk and prognostic factors. Keywords Pilocytic astrocytoma . Spinal cord . Imaging features . Prognosis
Introduction Pilocytic astrocytoma (PA) is an extremely rare subtype of gliomas with slow-growing nature [9, 25]. The tumor cells Liang Zhang and Teng Li contributed equally to this work. This article is part of the Topical Collection on Tumor - Glioma The hospital in the article refers to the Chinese PLA General Hospital * Xinguang Yu [email protected] 1
Medical School of Nankai University, No. 94, Weijin Road, Naikai District, Tianjin 300071, People’s Republic of China
2
Department of Neurosurgery, The First Medical Center, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, People’s Republic of China
3
Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
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