Grade II Pleomorphic Xanthoastrocytoma; a meta-analysis of data from previously reported 167 cases. (August 2018)

• Record Type: Journal Article
• Authors: Mallick, Supriya; Benson, Rony; Melgandi, Wineeta; Giridhar, Prashanth; Rath, G.K.
• Is Part Of: Journal of clinical neuroscience. Volume 54(2018)
• Page Start: 57
• Page End: 62
• Publication Date: 2018-08
• Subjects: Pleomorphic Xanthoastrocytoma -- Adjuvant -- Chemotherapy -- Radiotherapy -- Surgery; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2018.05.003
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Pleomorphic Xanthoastrocytoma [PXA] is a rare low grade glial tumor. 167 patients from 89 articles were included in the analysis. Use of adjuvant therapy was not found to be significant factor affecting progression free survival or overall survival. Younger patients and patients who undergo a GTR, have a better survival outcomes. Abstract: Pleomorphic Xanthoastrocytoma [PXA] is a rare low grade glial tumor commonly affecting young adults. We did this systematic review and meta-analysis to identify prognostic factors and optimal treatment in these patients. A thorough search of the PubMed, Google scholar was made to find all possible publications related to grade II PXA. A total of 167 patients from 89 articles were included in the analysis. Median age of the entire cohort was 20 years. Headache was the most common presentation in 49.1% of the patients followed by seizure in 27.9%. Temporal lobe was the most common location of the tumor. 63% patents underwent a gross total resection [GTR] and 26.7% underwent a sub total excision [STR]. Adjuvant radiation was given to 17.6% of patients. Median follow-up for the entire cohort was 33 months. Estimated median overall survival [OS] for the entire cohort was 209.0 months [96% CI: 149.7–268.3]. Estimated median progression free survival [PFS] was 48 months [95% CI: 31.9–64.0]. In univariate and multivariate analysis younger patients and patients who underwent a GTR had a significantly better survival outcome. Use of adjuvant therapy was not found to be a significant factor affecting PFS or OS. Radiotherapy was used in salvage treatment in 76.1% of the patients. Younger patients and patients who undergo a GTR, have better survival outcomes. There is inadequate evidence to recommend routine adjuvant radiation or chemotherapy in all patients with grade II PXA.