• World Neurosurg · Jan 2020

    Observational Study

    Adult pilocytic astrocytomas: a Brazilian series.

    • Gabriela Boschetti, Adrialdo Jose Santos, Kellen Paiva Fermon, de Freitas Honório Gustavo Lopes GL Department of Neurosurgery, Neuro-oncology Service, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., Gabriel Batistella, Solena Ziemer Kusma, João Norberto Stávale, de Paiva Neto Manoel Antonio MA Department of Neurosurgery, Neuro-oncology Service, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., and Fleury Malheiros Suzana Maria SM Department of Neurosurgery, Neuro-oncology Service, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Department of Oncolo.
    • Department of Neurosurgery, Neuro-oncology Service, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; School of Medicine Deparment, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil; Medical School Department, Faculdades Pequeno Príncipe, Curitiba, Paraná, Brazil. Electronic address: gabiboschetti@hotmail.com.
    • World Neurosurg. 2020 Jan 1; 133: e115-e120.

    ObjectivePilocytic astrocytoma (PA) is rare in adults comprising 5.1% of the primary central nervous system tumors. The aim is to describe the first Brazilian series of adult patients with PA and compare its features with the available literature.MethodsWe retrospectively review all patients 18 years or older with PA from our institution's database from 1991 to 2018. We analyzed information regarding clinical presentation, location, imaging features, extent of resection, adjuvant treatments, and follow-up.ResultsTwenty-three patients with PA were analyzed: 60.9% male; median age 26 years. The most frequent symptoms were headache (34.8%) and seizure (26.1%). Temporal and parietal lobes were the most common locations, 21.7% each. All patients underwent a surgical procedure, gross total resection in 40.9%, subtotal resection in 22.7%, and biopsy in 27.3%. Adjuvant treatment with radiotherapy was performed in 2 patients. Only 4 patients had disease progression, 2 after gross total resection and 2 after subtotal resection. They were all alive and without evidence of new progression at the last follow-up (October 2018). Median overall survival was not reached after a median follow-up time of 88.9 months.ConclusionsThis is the first Brazilian series regarding adults with PA, and our patients had a favorable outcome as reported in recent literature reviews. The tumor's prevalence reduces within older patients and supratentorial lesions are more frequent, especially on the temporal lobe. There was no significant relationship between location and progression, although according to the literature the extent of resection remains the most important prognostic factor.Copyright © 2019 Elsevier Inc. All rights reserved.

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