Astrocytomas

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Astrocytomas

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Astrocytomas are primary central nervous system tumors that arise primarily in and rarely spread away from the CNS parenchyma contained within the cranial vault. Astrocytomas “are CNS neoplasms in which the predominant cell type is derived from an immortalized astrocyte and account for roughly 75% of neuroepithelial tumors. In 1993 the World Health Organization (WHO) established a four-tiered histologic grading guideline for astrocytomas in an effort to eliminate confusion regarding diagnoses. The low grade astrocytomas (I & II) are among the least common of all reported brain tumors, less than 6%, while the highest grade (IV), also known as glioblastoma multiforme (GBM), is the most common primary CNS malignancy and second most frequent brain tumor. Despite the comparatively low incidence of astrocytomas to other human cancers, the higher grades (III & IV) represent disparate mortality rates. Median survival of GBM victims who forgo treatment is approximately 90 days, and even with aggressive surgical, radio- and chemo- therapies is only extended to about twelve months, while long term survival (at least five years) falls under 3%.</p>


Treatment</p>


For low grade astrocytomas, removal of the tumor will generally allow functional survival for many years. In some reports, the 5 year survival has been over 90% with well resected tumors. Indeed, broad intervention of low grade conditions is a contested matter. In particular, pilocytic astrocytomas are commonly indolent bodies that may permit normal neurologic function. However, left unattended these tumors may eventually undergo neoplastic
To date, complete resection of high grade astrocytomas is impossible because of the diffuse infiltration of tumor cells into normal parenchyma. Thus, high grade astrocytomas inevitably recur after initial surgery/therapy and are usually treated similarly as the initial tumor. Despite decades of therapeutic research, curative intervention is still nonexistent for high grade astrocytomas; patient care ultimately focuses on palliative management.</p>

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