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ORIGINAL ARTICLE
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 29-37

Prognostic significance of modified Pignatti score in patients with World Health Organization grade II diffuse astrocytomas


1 Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Edmond J Gandham
Department of Neurological Sciences, Christian Medical College, Vellore 632004, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJNO.IJNO_9_21

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The aim of this study was to validate the modified Pignatti scoring system as a predictor of survival in patients with World Health Organization (WHO) grade II diffuse fibrillary astrocytomas (DFAs). In this retrospective cohort study, data were collected from 135 consecutive patients who underwent excision/biopsy of WHO grade II DFAs from January 2000 to December 2015. The effect of the following prognostic variables on overall survival (OS) and progression-free survival (PFS) was studied: Pignatti score (PS = 1–4, low versus high risk), location of tumor (lobar versus nonlobar), extent of resection (subtotal resection [STR] versus <STR), and presence of enhancement (yes versus no). The median age was 42 years (range = 13–81 years) with male to female ratio of 1.8. A total of 99 patients had taken radiation therapy and had a follow-up >1 year (median follow-up = 5.2 years, range = 1–16 years). In all, 80 patients (81%, PS = 1–2) were in the low-risk group. The median PFS in the low-risk group (PS = 1 and 2) was 120 months (95% confidence interval [CI] = 72, 128). The median PFS in the high-risk group (PS = 3 and 4) was 72 months (95% CI = 18, not applicable [NA]). The median OS in the low-risk group was significantly higher at 128 months (95% CI = 72, NA) as compared to 72 months (95% CI = 18, NA) in the high-risk group (P = .005). The modified PS can be used to prognosticate survival in patients with WHO grade II DFAs, with patients of the low-risk category having a better OS but not PFS.


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