Proliferative potential and prognostic evaluation of low-grade astrocytomas |
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Authors: | Satoyuki Ito Kym L. Chandler Michael D. Prados Kathleen Lamborn Janet Wynne Mary K. Malec Charles B. Wilson Richard L. Davis Takao Hoshino |
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Affiliation: | (1) Neuro-Oncology Service, School of Medicine, University of California, 94143 San Francisco, CA, USA;(2) Brain Tumor Research Center, Department of Neurological Surgery, School of Medicine, University of California, 94143 San Francisco, CA, USA;(3) Division of Neuropathology, Department of Pathology, School of Medicine, University of California, 94143 San Francisco, CA, USA;(4) Quintiles Pacific, Inc., 94041 Mountain View, CA, USA;(5) Department of Neurological Surgery, Kyorin University, School of Medicine, Tokyo, Japan;(6) Department of Neurological Surgery, The Editorial Office, 1360 Ninth Avenue, Suite 210, 94122 San Francisco, CA, USA |
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Abstract: | Summary Despite their histological similarity, low-grade astrocytomas vary widely in their clinical behavior. To elucidate this variable behavior, we measured the proliferative potential of 69 primary and 18 recurrent low-grade astrocytomas and correlated the results with the clinical characteristics and outcome. Each patient received an intravenous infusion of bromodeoxyuridine (BUdR); BUdR-labeled nuclei in excised tumor specimens were identified by immunoperoxidase staining. The BUdR labeling index (LI), or S-phase fraction, ranged from <1 to 9.3%; the LI was < 1% in 64 (74%) patients and 1% in 23 patients (26%). The LI did not appear to be associated with age, sex, tumor location, or whether the tumor was primary or recurrent. A Cox proportional-hazards analysis of the influence of the LI and other variables (age, sex, tumor location, extent of surgery, primary versus recurrent tumor) on survival showed that the LI and extent of surgery (total resection, subtotal resection, biopsy) were significant in predicting both survival and progression-free survival for all patients and for patients with primary tumors. The LI was also significant in predicting progression-free survival for patients with recurrent tumors. The correlation between the BUdR LI and both survival and time to recurrence suggests that the outcome of low-grade astrocytomas varies according to the proliferative potential. The growth rate of these histologically similar tumors should be assessed individually in order to select specific treatment.Deceased January 28, 1993 |
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Keywords: | astrocytoma bromodeoxyuridine cell kinetics prognosis |
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