Tumour vascularity is of prognostic significance in adult, but not paediatric astrocytomas

B Birlik, S Canda, E Ozer - Neuropathology and applied …, 2006 - Wiley Online Library
B Birlik, S Canda, E Ozer
Neuropathology and applied neurobiology, 2006Wiley Online Library
Astrocytomas are the commonest type of brain tumours in adults and children. Although the
most reliable prognostic indicators have been shown consistently to be patient age and
tumour histological grade, biological progression in these tumours is inevitable and the
overall prognosis has remained poor. Due to the evidence that vascular changes are
important histological features of astrocytomas, the aim of this study was to investigate
prognostic significance of tumour vascularity in paediatric and adult astrocytomas. Study …
Astrocytomas are the commonest type of brain tumours in adults and children. Although the most reliable prognostic indicators have been shown consistently to be patient age and tumour histological grade, biological progression in these tumours is inevitable and the overall prognosis has remained poor. Due to the evidence that vascular changes are important histological features of astrocytomas, the aim of this study was to investigate prognostic significance of tumour vascularity in paediatric and adult astrocytomas. Study population consisted of 70 patients (45 adult and 25 children) with histologically proven diagnosis of astrocytoma with no history of previous therapy. Histological quantification of tumour vascularity was performed using three different methods: microvessel density, vascular grading and Chalkley counting. Histological classification and grading were also assessed using the World Health Organization system. In contrast to the results in paediatric astrocytomas, tumour vascularity in adult tumours correlated significantly with postoperative survival by univariate analysis (P < 0.05). Microvessel density appeared to be an independent indicator of prognosis by multivariate analysis (P = 0.001). Likewise, patients with microvessel density of 70 or greater had significantly shorter survival than the remaining group (P < 0.001). Patient age and tumour histological grade were also correlated with survival. We conclude that histological quantification of tumour vascularity is a significant prognosticator in adult astrocytomas, but not in children. Our data do not support the validity of applications of antiangiogenic agents in paediatric astrocytic tumours, particularly pilocytic astrocytomas.
Wiley Online Library