Outcome Analysis Of Pilocytic Astrocytoma:Surgical Treatment And Prognosis

ObjectiveTo explore the efficacy and safety of surgical treatment of pilocytic astrocytoma.MethodsPatients with pilocytic astrocytoma had been recruited in this retrospective study by the Department of Neurosurgery of the Second Affiliated Hospital of Zhejiang University School of Medicine from January2004to December2014. The clinical manifestations, the efficacy and safety of surgical treatment, and the long-term prognosis were analyzed in the present study.ResultsTotally101patients (50males and51females, age range3to69years) with pilocytic astrocytoma were included in the analysis. The most common location of tumor was cerebellum (70patients). And the other locations included cerebral parenchyma (19patients), paracele or ventriculus tertius (7patients), spinal canal (4patients), brainstem (1patient). The major clinical symptoms were dizziness, gait instability, weakness in limbs, and epilepsy which depends on the mass effect of tumor. Total removal rate was60.4%(61patients) and subtotal removal were due to the tumor location near function regions like medulla oblongata. The postoperative complications were dystaxia (23patients), paresis (4patients), congnitive (8patients), decreased vision (1patients), epilepsy (3patients), active hydrocephalus (4patients), death (10patient). And the five-year OS is89.6%, PFS is83.3%.ConclusionsSurgical resection of tumor was regarded as the effective way with high total removal rate and five-year survival rate in treatment of pilocytic astrocytoma. Paatial surgical removal, hypothalamo-chiasmatic location and PMA are strong adverse prognostic factors of outcome on both PFS and OS. Studies reported a positive correlation between location and the age of patients. There is also a positive correlation between removal percentage and hydrocephalus. However, it should be noticed that postoperative hydrocephalus, especially in the tumor infringing ventricular system.