Clinicopathologic features and early surgical outcome of astrocytomas in Eldoret, Kenya (original) (raw)
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Astrocytomas include a wide range of tumors with unique mutations and varying grades of malignancy. These tumors all originate from the astrocyte, a star-shaped glial cell that plays a major role in supporting functions of the central nervous system (CNS), including blood-brain barrier (BBB) development and maintenance, water and ion regulation, influencing neuronal synaptogenesis, and stimulating the immunological response. In terms of epidemiology, glioblastoma (GB), the most common and malignant astrocytoma, generally occur with higher rates in Australia, Western Europe, and Canada, with the lowest rates in Southeast Asia. Additionally, significantly higher rates of GB are observed in males and non-Hispanic whites. It has been suggested that higher levels of testosterone observed in biological males may account for the increased rates of GB. Hereditary syndromes such as Cowden, Lynch, Turcot, Li-Fraumeni, and neurofibromatosis type 1 have been linked to increased rates of astrocy...
Prevalence of primary CNS tumors in a diagnostic setup in Nairobi, Kenya
Indian Journal of Pathology and Oncology, 2018
Introduction: Diagnosis of CNS tumors is often difficult for the general pathologist due to its rarity. However, high morbidity and mortality makes this the dreaded form of cancer and diagnosis requires precision to differentiate the various forms including secondaries. Materials and Methods: Study was conducted in an independent laboratory over a period of 6 months in Nairobi, Kenya and all primary CNS neoplasms during the study period were included in the study. Result: Amongst 42 lesions involving the CNS, 34 primary CNS neoplasms were identified. It was more common in females with a mean age of 49.41 years. Meningiomas were the most common type of CNS lesions followed by astrocytic tumors. Conclusion: Incidence of meningiomas is high in the African population. Light microscopy is essential for initial diagnosis, however, immunohistochemistry, ultrastructural studies including molecular studies are essential to predict further management.
Low-grade astrocytoma - A retrospective analysis of 102 patients
Acta Oncologica
One hundred and two patients (57 males, 45 females, median age 17 years) with histologically proven low-grade astrocytoma (grades I, II) treated between 1978 and 1994 were retrospectively analyzed at the King Faisal Specialist Hospital & Research Center. Microscopic investigation showed 50 patients (48%) with grade I tumors as opposed to 52 patients (52%) with grade II tumors. Fifteen patients (15%) had complete surgical excision, 55 (52%) had partial excision and 32 (31%) had biopsy only; 68 patients (66%) received external radiotherapy with a median dose of 54 Gy (range 45-68.5 Gy). With a median follow-up of 3.3 years, the 5 and 10 years' overall actuarial survival rates were 78% and 62%, respectively while the progression-free survival rates at 5 and 10 years were 69% and 35%, respectively. Age and performance status were significant prognostic factors in terms of overall survival on univariate (p =0.05 and 0.05, respectively) and multivariate analysis (p =0.005 and 0.006, respectively).
Survival of Brain Astrocytoma Patients Considering Preoperative Tumor Size
Acta Medica Medianae, 2007
Actual neuroradiological diagnostics of the brain tumors, including astrocytomas, is of great influence on successful planning and realization of the tumor resection, considering the fact that it is often preoperative. CT diagnostics is the most frequently used method of the brain tumor visualization in Serbia, due to height reliability, short time of the exposition, lower costs, and wide using even in smaller health centers, comparing to competitive methods. In our study, we examined 63 patients of different sex and age, which have been operated for a brain tumor at the Neurosurgery Clinic in Nis. Brain astrocytoma has been found in all patients after pathohistological evaluation of the operatively resected material. All patients had maximal reduction of the tumor bulk and postoperatively were treated according to current oncological protocols. The preoperative CT parameter-tumor size was correlated to survival.The most often tumor bulk was presented as medium-sized, average diamet...
Journal of National Institute of Neurosciences Bangladesh
Background: Glioma is the most commonly occurring malignant brain tumor that varies by age, sex, race or ethnicity. A very few number of records on CNS tumors are available in Bangladesh. National Institute of Neurosciences and Hospital (NINS), Dhaka has a good number of CNS surgeries. Regularly both tumorous and non-tumorous ICSOL samples are examined here. Objective: The aim of the study was to see the subtypes, frequency and topography of Astrocytic tumors at NINS setting. Methodology: Data from the department of Neuropathology department of NINS since January 2013 to June 2019 were evaluated. Tissue were fixed in formalin, paraffin embedded, stained with H&E. Histomorphology and WHO 2007 CNS tumor classification were used. Result: From 3945 routine sample 567 cases were sorted out as Astrocytic tumor. Total male were 61% (346) and female 39% (221), male to female ratio was 1.6:1. The mean age was 32.64 and ranged from 1 to 80 years. Sixty six percent (66%) tumors were in suprate...
Astrocytoma: Insights into Risk Factors, Pathogenesis, Diagnosis and Management
2018
Astrocytoma is one of the most common types of brain tumors. It arises from astrocytes-star-shaped cells that make up the i°glue-likei± or supportive tissue of the brain. There are different types and severities of Astrocytomas. According to (WHO),It can be classified into grades from I to IV. The most frequently diagnosed types of astrocytoma are pilocytic astrocytoma, grade II astrocytoma, anaplastic astrocytoma and glioblastoma multiforme. They may or may not be cancerous. The exact cause of astrocytoma is unknown. Astrocytomas occur slightly more often in men than in women. They are slightly more common in Caucasians. Astrocytomas can develop in both children and adults. The diagnosis of astrocytoma is based on a thorough clinical evaluation, characteristic physical findings, a careful patient history, and specialized tests. Astrocytomas may be treated with surgery, radiation therapy, chemotherapy or a combination of treatments.
Survival in malignant astrocytoma at King Khalid University Hospital
Annals of Saudi medicine, 1995
Malignant astrocytoma (Kernohan grade III and IV) still has one of the worst outcomes of all malignant tumors. To determine factors affecting the survival of patients with malignant astrocytoma in Saudi Arabia, a retrospective study of 76 cases that were treated at King Khalid University Hospital over one decade was carried out. Kaplan-Meier survival diagrams were constructed for each prognostic factor. Twenty-eight percent of cases survived two years. A significantly better survival rate was found in females, patients </=50 years and patients who had re-operation for a recurrence. A better survival rate which did not reach significance was found in patients with grade III tumors, patients with a Karnofsky score of >/=70 at presentation, patients who had craniotomy and excision and patients who had radiotherapy. It is suggested that to improve the outcome of patients with malignant astrocytoma, aggressive surgical excision with radiotherapy (and possibly chemotherapy) is requi...
Low-grade astrocytoma: surgical outcomes in eloquent versus non-eloquent brain areas
Arquivos de Neuro-Psiquiatria, 2013
A retrospective study of 81 patients with low-grade astrocytoma (LGA) comparing the efficacy of aggressive versus less aggressive surgery in eloquent and non-eloquent brain areas was conducted. Extent of surgical resection was analyzed to assess overall survival (OS) and progression- free survival (PFS). Degree of tumor resection was classified as gross total resection (GTR), subtotal resection (STR) or biopsy. GTR, STR and biopsy in patients with tumors in non-eloquent areas were performed in 31, 48 and 21% subjects, whereas in patients with tumors in eloquent areas resections were 22.5, 35 and 42.5%. Overall survival was 4.7 and 1.9 years in patients with tumors in non-eloquent brain areas submitted to GTR/STR and biopsy (p=0.013), whereas overall survival among patients with tumors in eloquent area was 4.5 and 2.1 years (p=0.33). Improved outcome for adult patients with LGA is predicted by more aggressive surgery in both eloquent and non-eloquent brain areas.
Astrocytic tumors in children: treatment results from a single institution
Child's Nervous System, 2007
Objective The aims of this study are to evaluate the patients with astrocytomas and to investigate survival rates and prognosis. Patients and methods Five hundred fourteen patients diagnosed with brain tumor between 1972 and 2003 were retrospectively analyzed. Three different chemotherapy regimens were used according to years. CCNU-based protocols were used in the early years; COPP (cyclophosphamide, oncovin, procarbazine, prednisolone) and CDDP+VP16 (cisplatinum + etoposide) were the other protocols used in the following years. Radiotherapy was used after 3 years of age according to protocols. Results Ninety-eight (19%) out of 514 patients have astrocytic histopathology. The histopathologic distribution was as follows: low grade, 55 patients; high grade, 43 patients. COPP regimen was given to 24 patients, CCNUbased regimen to 13, and CDDP+VP16 to 10 patients. We did not use any chemotherapy in 51 patients. Overall survival (OS) and event free-survival rates were 59.2 and 45.7% in whole group. OS rates were 93.3 and 22.4% for low-grade and high-grade histopathology, respectively (p=0.0001). OS for CCNU, CDDP+VP16, and COPP were 35.9, 22.8, and 30.4%, respectively. Conclusion Low-grade astrocytomas are highly responsive to the surgery, and they do not need any further treatment unless the patient has relapse or recurrence. Still, the treatment of the high-grade tumors is a problem, and it needs new treatment approaches.
Pediatric Brain tumors in Southeast Nigeria; A prospective longitudinal cohort study
2019
Background: Pediatric brain tumors (PBT’s) from previous studies are associated with poor outcomes in our sub region. Methods. An 8 -year single center prospective study. All cases investigated with neuroimaging and treated were enrolled. Data was analyzed with SPSS (Inc.) Chicago IL, USA version 23. Chi Square test, One-way Anova and confidence limits were used to evaluate associations at the 95% level of significance. Ethical approval was obtained for our study. Results: 103 patients were enrolled, 92 satisfied the study criteria. There were 45 males and 39 females, M: F=0.8. The mean age was 9.5±2.1 years 95%CI with a range of 7 months to 16 years. The most common symptom was headache for supratentorial lesions (73%) and gait disturbance (80.2%) for infratentorial lesions. More tumors were supratentorial in location (51 (55.4%), while 35(38.1%) were infratentorial. Craniopharyngiomas (n=22), medulloblastomas (n=17) and astrocytomas (n=12) were the most common tumors. Hemoglobin g...