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  • Astrocytic Brain Tumors in a Sub-Saharan African Population: Is the Relationship Between Location and Outcome an Age Dependent Prognostic Paradigm?

    Final Number:

    Enoch Ogbonnaya Uche MBBS

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Although astrocytomas are the most common primary brain tumors worldwide, they are still poorly reported in our environment.Moreso, clincal outcome determinants have been poorly investigated in our subregion

    Methods: We prospectively studied adult patients with astrocytic tumors in 3 tertiary hospitals within southeast Nigeria over a 5 year period. Patients’ clinical data as well as radiology and histology reports were analyzed. Follow- up interval was 3months to 4.5 years. Data analysis was performed using SPSS version 17 with evaluation of confidence limits, Chi Square tests at the 95% level of significance

    Results: Of 61 patients with neuroimaging features of brain astrocytoma , while 46 patients had histological confirmation. Mean age was 43.4±1.7 years (95% CI), low grade tumors- 35.3±0.9years (95%CI), high grade tumor patients - 49.6±0.4 years (95%CI). 37 patients were male and 24 were female with M:F ratio of 1.5. Major complaints were headache and seizures in 70.5 %( 43 patients) and 58.3 %( 35 patients) respectively, Duration of symptoms was 2 months to 17 months with a mean of 9.6±1.7 (95%CI) months. 41 cases were supratentorial, 17 cases were infratentorial, while 3 cases were transtentorial. 33patients had microsurgical resections, 11 had biopsy only, while 31 had CSF diversion.13 patients had low grade tumors (WHO grades I and II) , while 36 patients were high grade(WHO grades III and IV). Survival rates after 1year and 3 years follow up were 77% and 61% for low grade tumors and 27% and 8.3% for high grade tumors. Tumors in the supratentorial compartment in patients below 45 years were associated with longer survival across the tumor grades (X2=7.9, df =1, p<0.05). Infratentorial location was associated with poor overall outcome as well as shorter progression free survival in patients below 45 years with high grade tumors (X2=5.7, df=1,p<0.05)

    Conclusions: Supratentorial location is associated with better survival among younger adults with astrocytomas regardless of grade.

    Patient Care: treatment planning and prognostication

    Learning Objectives: The location of an astrocytoma and age significantly influence outcome and should be important consideration in clinical prognostication


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