Corpus callosum involvement as a prognostic factor for patients with high-grade astrocytoma

Purpose: To evaluate corpus callosum involvement as a prognostic factor for patients,vith high-grade astrocytoma. Methods: From 1986 through 1994, 141 adult patients with Karnofsky performance status (KPS) greater than or equal to 40 underwent primary treatment for anaplastic astrocytoma (AA) or glioblastoma multiforme (GEM) at the University of Washington Medical Center, Preoperative magnetic resonance imaging and/or computed tomography to assess corpus callosum involvement was available for 105 of these patients. Corpus callosum involvement was evaluated as a prognostic factor for survival using recursive partitioning analysis and multivariate analysis with a Cox proportional hazards model. Results: For the 105 patients evaluable for corpus callosum involvement, the median and 2-year survival were 59 weeks and 28%, respectively, On multivariate analysis, the only independent prognostic factors were KPS (p = 0.0001) and histology (p = 0.042), On recursive partitioning analysis, the first significant split occurred at KPS < 70 vs. KPS greater than or equal to 70. Patients with KPS greater than or equal to 70 were split by age (< 50 years vs, greater than or equal to 50 years), with those younger than 50 years further split by absence or presence of corpus callosum involvement, Among patients with KPS greater than or equal to 70 and age < 50 years, median survival was 57 weeks if the corpus callosum was involved (35% 2-year survival) and 105 weeks if the corpus callosun was not involved (56% 2-year survival). Conclusion: Corpus callosum involvement based on preoperative imaging is an unfavorable prognostic factor for survival among the subgroup of young, good-performance-status patients with high-grade astrocytoma. (C) 1997 Elsevier Science Inc.