Skip to main content
SpringerLink
Log in

Patterns of care and survival outcomes in patients with astroblastoma: an individual patient data analysis of 152 cases

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Background

Astroblastoma (AB) is a rare tumor with significant dilemma regarding diagnostic criteria, behavior, and optimum treatment.

Materials and methods

We searched PubMed, Google Search, and Cochrane Library for eligible studies with the following search words: astroblastoma, high-grade astroblastoma, and anaplastic astroblastoma till July 1, 2016, published in English language and collected data regarding age, sex, site of disease, pathological grade, treatment received, and survival.

Results

Data of 152 patients were retrieved from 63 publications. Median age was 16 years (range 0–71). Females were affected twice more frequently than male (70.3 vs. 29.7%). Tumors were most commonly located in the frontal (39%) followed by parietal lobe (26.7%). Fifty-two and 25% of the patients had headache and seizure at presentation, 76.3% of the patients underwent a gross total resection, 41 out of 89 had a high-grade tumor, and 56 patients received adjuvant radiation with a median dose of 54 Gy (range 20–72). Adjuvant chemotherapy was used in 23 patients. Temozolomide was the most common drug used in 30% of the patients. A combination of cisplatin, etoposide with vincristine, or ifosfamide was used in 17%. Median follow-up duration was 37 months (range 1–238). Median progression-free survival and OS were 36 and 184 months, respectively. Patients with a higher-grade tumor had significantly worse OS with HR 5.260 and p = 0.001. Forty patients experienced local progression. Sixty-five percent patients underwent surgery while 50% underwent radiation as salvage.

Conclusion

AB has two distinct grades with higher-grade tumors having significantly poor survival. Maximal safe surgery followed by adjuvant radiation and temozolomide should be advocated for these tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Bailey P, Cushing H (1926) A classification of the tumors of the glioma group on a histogenetic basis with a correlated study of prognosis. J.B. Lippincott Co., Philadelphia

    Google Scholar 

  2. Sughrue ME, Choi J, Rutkowski MJ, Aranda D, Kane AJ, Barani IJ et al (2011 Jun) Clinical features and post-surgical outcome of patients with astroblastoma. J Clin Neurosci 18(6):750–754

    Article  PubMed  Google Scholar 

  3. Ahmed KA, Allen PK, Mahajan A, Brown PD, Ghia AJ (2014) Astroblastomas: a Surveillance, Epidemiology, and End Results (SEER)-based patterns of care analysis. World Neurosurg 82(1–2):e291–e297

    Article  PubMed  Google Scholar 

  4. Lehman NL, Hattab EM, Mobley BC, Usubalieva A, Schniederjan MJ, McLendon RE et al. Morphological and molecular features of astroblastoma, including BRAFV600E mutations, suggest an ontological relationship to other cortical-based gliomas of children and young adults. Neuro Oncol. 2016 Jul 14. pii: now118. PMID: 27416954.

  5. Brat DJ, Hirose Y, Cohen KJ, Feuerstein BG, Burger PC (2000) Astroblastoma: clinicopathologic features and chromosomal abnormalities defined by comparative genomic hybridization. Brain Pathol 10(3):342–352

    Article  CAS  PubMed  Google Scholar 

  6. Louis DN, Ohgaki H, Wiestler OD et al (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bale TA, Abedalthagafi M, Bi WL, Kang YJ, Merrill P, Dunn IF et al (2016) Genomic characterization of recurrent high-grade astroblastoma. Cancer Genet 209(7–8):321–330

    Article  CAS  PubMed  Google Scholar 

  8. Yeo JJ, Low YY, Putti TC, Koh KM (2016) Adult intraventricular astroblastoma. Singap Med J 57(1):53–54

    Article  Google Scholar 

  9. Yuzawa S, Nishihara H, Tanino M, Kimura T, Moriya J, Kamoshima Y et al (2016) A case of cerebral astroblastoma with rhabdoid features: a cytological, histological, and immunohistochemical study. Brain Tumor Pathol 33(1):63–70

    Article  CAS  PubMed  Google Scholar 

  10. Singla N, Dhandapani SS, Kapoor A, Chatterjee D, Vashishta RK (2016) Hemorrhage in astroblastoma: an unusual manifestation of an extremely rare entity. J Clin Neurosci 25:147–150

    Article  PubMed  Google Scholar 

  11. Narayan S, Kapoor A, Singhal MK, Jakhar SL, Bagri PK, Rajput PS, Kumar HS (2015) Astroblastoma of cerebrum: a rare case report and review of literature. J Cancer Res Ther 11(3):667

    PubMed  Google Scholar 

  12. Sabharwal P, Sadashiva N, Unchagi A, Mahadevan A, Pandey P (2015) Intraventricular Astroblastoma in an infant: a case report and review of the literature. Pediatr Neurosurg 50(6):325–329

    Article  PubMed  Google Scholar 

  13. Yao K, Wu B, Xi M, Duan Z, Wang J, Qi X (2015) Distant dissemination of mixed low-grade astroblastoma-arteriovenous malformation after initial operation: a case report. Int J Clin Exp Pathol 8(6):7450–7456 eCollection 2015

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Samkari A, Hmoud M, Al-Mehdar A, Abdullah S (2015) Well-differentiated and anaplastic astroblastoma in the same patient: a case report and review of the literature. Clin Neuropathol 34(6):350–358

    Article  PubMed  Google Scholar 

  15. Mellai M, Piazzi A, Casalone C, Grifoni S, Melcarne A, Annovazzi L et al (2015) Astroblastoma: beside being a tumor entity, an occasional phenotype of astrocytic gliomas? Onco Targets Ther 8:451–460

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Janz C, Buhl R (2014) Astroblastoma: report of two cases with unexpected clinical behavior and review of the literature. Clin Neurol Neurosurg 125:114–124

    Article  PubMed  Google Scholar 

  17. de la Garma VH, Arcipreste AA, Vázquez FP, Aguilar RR, Castruita UO, Guerra RM (2014) High-grade astroblastoma in a child: report of one case and review of literature. Surg Neurol Int 5:111

    Article  PubMed  PubMed Central  Google Scholar 

  18. Singh DK, Singh N, Singh R, Husain N (2014) Cerebral astroblastoma: a radiopathological diagnosis. J Pediatr Neurosci 9(1):45–47

    Article  PubMed  PubMed Central  Google Scholar 

  19. Barakat MI, Ammar MG, Salama HM, Abuhashem S (2016) Astroblastoma: case report and review of literature. Turk Neurosurg 26(5):790–794

    PubMed  Google Scholar 

  20. Yao K, Li TF, Zhu MW, Duan ZJ, Liu CQ, Wang JQ et al (2013) Mixed astroblastoma-arteriovenous malformation complex: a case report. Neurol India 61(4):439–442

    Article  PubMed  Google Scholar 

  21. Nasit JG, Trivedi P (2013) Recurrent low-grade astroblastoma with signet ring-like cells and high proliferative index. Fetal Pediatr Pathol 32(4):284–292

    Article  PubMed  Google Scholar 

  22. Khosla D, Yadav BS, Kumar R, Agrawal P, Kakkar N, Patel FD et al (2012) Pediatric astroblastoma: a rare case with a review of the literature. Pediatr Neurosurg 48(2):122–125

    Article  PubMed  Google Scholar 

  23. Agarwal V, Mally R, Palande DA, Velho V (2012) Cerebral astroblastoma: a case report and review of literature. Asian J Neurosurg 7(2):98–100

    Article  PubMed  PubMed Central  Google Scholar 

  24. Bhattacharjee S, Pulligopu AK, Uppin MS, Sundaram C (2011) Astroblastoma with bone invasion. Asian J Neurosurg 6(2):113–115

    Article  PubMed  PubMed Central  Google Scholar 

  25. Bergkåsa M, Sundstrøm S, Gulati S, Torp SH (2011) Astroblastoma—a case report of a rare neuroepithelial tumor with complete remission after chemotherapy. Clin Neuropathol 30(6):301–306

    Article  PubMed  PubMed Central  Google Scholar 

  26. Johnson KA, Bonnin JM, Boaz JC, Douglas-Akinwande AC, Hattab EM (2010) Anaplastic astroblastoma presenting as massive, sudden-onset, intraparenchymal hemorrhage. Pediatr Neurosurg 46(6):457–461

    Article  PubMed  Google Scholar 

  27. Binesh F, Akhavan A, Navabii H, Mehrabaniyan M. Anaplastic astroblastoma: a rare glial tumour. BMJ Case Rep. 2011 Sep 28;2011. pii: bcr0620114323.

  28. Weintraub D, Monteith SJ, Yen CP, Schlesinger D, Rich T, Sheehan J (2011) Recurrent astroblastoma treated with gamma knife radiosurgery. J Neuro-Oncol 103(3):751–754

    Article  Google Scholar 

  29. Mastrangelo S, Lauriola L, Coccia P, Puma N, Massimi L, Riccardi R (2010) Two cases of pediatric high-grade astroblastoma with different clinical behavior. Tumori 96(1):160–163

    PubMed  Google Scholar 

  30. Kemerdere R, Dashti R, Ulu MO, Biçeroğlu H, Demiröz AS, Albayram S et al (2009) Supratentorial high grade astroblastoma: report of two cases and review of the literature. Turk Neurosurg 19(2):149–152

    PubMed  Google Scholar 

  31. Kantar M, Ertan Y, Turhan T, Kitis O, Anacak Y, Akalin T et al (2009) Anaplastic astroblastoma of childhood: aggressive behavior. Childs Nerv Syst 25(9):1125–1129

    Article  CAS  PubMed  Google Scholar 

  32. Salvati M, D’Elia A, Brogna C, Frati A, Antonelli M, Giangaspero F et al (2009) Cerebral astroblastoma: analysis of six cases and critical review of treatment options. J Neuro-Oncol 93(3):369–378

    Article  Google Scholar 

  33. Eom KS, Kim JM, Kim TY (2008) A cerebral astroblastoma mimicking an extra-axial neoplasm. J Korean Neurosurg Soc 43(4):205–208

    Article  PubMed  PubMed Central  Google Scholar 

  34. Ganapathy S, Kleiner LI, Mirkin DL, Broxson E (2009) Unusual manifestations of astroblastoma: a radiologic-pathologic analysis. Pediatr Radiol 39(2):168–171

    Article  PubMed  Google Scholar 

  35. Denaro L, Gardiman M, Calderone M, Rossetto M, Ciccarino P, Giangaspero F et al (2008) Intraventricular astroblastoma. Case report J Neurosurg Pediatr 1(2):152–155

    Article  PubMed  Google Scholar 

  36. Fathi AR, Novoa E, El-Koussy M, Kappeler A, Mariani L, Vajtai I (2008) Astroblastoma with rhabdoid features and favorable long-term outcome: report of a case with a 12-year follow-up. Pathol Res Pract 204(5):345–351

    Article  PubMed  Google Scholar 

  37. Notarianni C, Akin M, Fowler M, Nanda A (2008) Brainstem astroblastoma: a case report and review of the literature. Surg Neurol 69(2):201–205

    Article  PubMed  Google Scholar 

  38. Unal E, Koksal Y, Vajtai I, Toy H, Kocaogullar Y, Paksoy Y (2008) Astroblastoma in a child. Childs Nerv Syst 24(2):165–168

    Article  PubMed  Google Scholar 

  39. Mangano FT, Bradford AC, Mittler MA, Valderrama E, Schneider SJ (2007) Astroblastoma. Case report, review of the literature, and analysis of treatment strategies. J Neurosurg Sci 51(1):21–27 discussion 27

    CAS  PubMed  Google Scholar 

  40. Bannykh SI, Fan X, Black KL (2007) Malignant astroblastoma with rhabdoid morphology. J Neuro-Oncol 83(3):277–278

    Article  Google Scholar 

  41. Tumialán LM, Brat DJ, Fountain AJ, Barrow DL (2007) An astroblastoma mimicking a cavernous malformation: case report. Neurosurgery 60(3):E569–E570 discussion E570

    Article  PubMed  Google Scholar 

  42. Alaraj A, Chan M, Oh S, Michals E, Valyi-Nagy T, Hersonsky T (2007) Astroblastoma presenting with intracerebral hemorrhage misdiagnosed as dural arteriovenous fistula: review of a rare entity. Surg Neurol 67(3):308–313

    Article  PubMed  Google Scholar 

  43. Bell JW, Osborn AG, Salzman KL, Blaser SI, Jones BV, Chin SS (2007) Neuroradiologic characteristics of astroblastoma. Neuroradiology 49(3):203–209

    Article  PubMed  Google Scholar 

  44. Kaji M, Takeshima H, Nakazato Y, Kuratsu J (2006) Low-grade astroblastoma recurring with extensive invasion. Neurol Med Chir (Tokyo) 46(9):450–454

    Article  Google Scholar 

  45. Hata N, Shono T, Yoshimoto K, Mizoguchi M, Kawamura T, Nagata S et al (2006) An astroblastoma case associated with loss of heterozygosity on chromosome 9p. J Neuro-Oncol 80(1):69–73

    Article  Google Scholar 

  46. Miranda P, Lobato RD, Cabello A, Gómez PA, Martínez de Aragón A (2006) Complete surgical resection of high-grade astroblastoma with long time survival: case report and review of the literature. Neurocirugia (Astur) 17(1):60–63

    Article  CAS  Google Scholar 

  47. Kubota T, Sato K, Arishima H, Takeuchi H, Kitai R, Nakagawa T (2006) Astroblastoma: immunohistochemical and ultrastructural study of distinctive epithelial and probable tanycytic differentiation. Neuropathology 26(1):72–81

    Article  PubMed  Google Scholar 

  48. Lau PP, Thomas TM, Lui PC, Khin AT (2006) Low-grade’ astroblastoma with rapid recurrence: a case report. Pathology 38(1):78–80

    Article  PubMed  Google Scholar 

  49. Huhn SL, Yung Y, Cheshier S, Harsh G, Ailles L, Weissman I et al (2005) Identification of phenotypic neural stem cells in a pediatric astroblastoma. J Neurosurg 103(5 Suppl):446–450

    PubMed  Google Scholar 

  50. Navarro R, Reitman AJ, de León GA, Goldman S, Marymont M, Tomita T (2005) Astroblastoma in childhood: pathological and clinical analysis. Childs Nerv Syst 21(3):211–220

    Article  PubMed  Google Scholar 

  51. Kim DS, Park SY, Lee SP (2004) Astroblastoma: a case report. J Korean Med Sci 19(5):772–776

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kim BS, Kothbauer K, Jallo G (2004) Brainstem astroblastoma. Pediatr Neurosurg 40(3):145–146

    Article  PubMed  Google Scholar 

  53. Caroli E, Salvati M, Esposito V, Orlando ER, Giangaspero F (2004) Cerebral astroblastoma. Acta Neurochir 146(6):629–633

    Article  CAS  PubMed  Google Scholar 

  54. Sugita Y, Terasaki M, Shigemori M, Morimatsu M, Honda E, Oshima Y (2002) Astroblastoma with unusual signet-ring-like cell components: a case report and literature review. Neuropathology 22(3):200–205

    Article  PubMed  Google Scholar 

  55. Port JD, Brat DJ, Burger PC, Pomper MG (2002) Astroblastoma: radiologic-pathologic correlation and distinction from ependymoma. AJNR Am J Neuroradiol 23(2):243–247

    PubMed  Google Scholar 

  56. Shuangshoti S, Mitphraphan W, Kanvisetsri S, Griffiths L, Navalitloha Y, Pornthanakasem W et al (2000) Astroblastoma: report of a case with microsatellite analysis. Neuropathology 20(3):228–232

    Article  CAS  PubMed  Google Scholar 

  57. Mierau GW, Tyson RW, McGavran L, Parker NB, Partington MD (1999) Astroblastoma: ultrastructural observations on a case of high-grade type. Ultrastruct Pathol 23(5):325–332

    Article  CAS  PubMed  Google Scholar 

  58. Thiessen B, Finlay J, Kulkarni R, Rosenblum MK (1998) Astroblastoma: does histology predict biologic behavior? J Neuro-Oncol 40(1):59–65

    Article  CAS  Google Scholar 

  59. Yunten N, Ersahin Y, Demirtas E, Yalman O, Sener RN (1996) Cerebral astroblastoma resembling an extra-axial neoplasm. J Neuroradiol 23(1):38–40

    CAS  PubMed  Google Scholar 

  60. Jay V, Edwards V, Squire J, Rutka J (1993) Astroblastoma: report of a case with ultrastructural, cell kinetic, and cytogenetic analysis. Pediatr Pathol 13(3):323–332

    Article  CAS  PubMed  Google Scholar 

  61. Cabello A, Madero S, Castresana A, Diaz-Lobato R (1991) Astroblastoma: electron microscopy and immunohistochemical findings: case report. Surg Neurol 35(2):116–121

    Article  CAS  PubMed  Google Scholar 

  62. Hoag G, Sima AA, Rozdilsky B (1986) Astroblastoma revisited: a report of three cases. Acta Neuropathol 70(1):10–16

    Article  CAS  PubMed  Google Scholar 

  63. Rubinstein LJ, Herman MM (1989) The astroblastoma and its possible cytogenic relationship to the tanycyte. An electron microscopic, immunohistochemical, tissue- and organ-culture study. Acta Neuropathol 78(5):472–483

    Article  CAS  PubMed  Google Scholar 

  64. Husain AN, Leestma JE (1986) Cerebral astroblastoma: immunohistochemical and ultrastructural features. Case reportJ Neurosurg 64(4):657–661

    CAS  Google Scholar 

  65. Yamashita J, Handa H, Yamagami T, Haebara H (1985) Astroblastoma of pure type. Surg Neurol 24(2):218–222

    Article  CAS  PubMed  Google Scholar 

  66. Pizer BL, Moss T, Oakhill A, Webb D, Coakham HB (1995) Congenital astroblastoma: an immunohistochemical study. Case report J Neurosurg 83(3):550–555

    CAS  PubMed  Google Scholar 

  67. Sener RN (2002) Astroblastoma: diffusion MRI, and proton MR spectroscopy. Comput Med Imaging Graph 26(3):187–191

    Article  CAS  PubMed  Google Scholar 

  68. Cunningham DA, Lowe LH, Shao L, Acosta NR (2016) Neuroradiologic characteristics of astroblastoma and systematic review of the literature: 2 new cases and 125 cases reported in 59 publications. Pediatr Radiol 46(9):1301–1308

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India

    Supriya Mallick, Rony Benson, Bhanuprasad Venkatesulu, Wineeta Melgandi & Goura K Rath

Authors
  1. Supriya Mallick
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rony Benson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bhanuprasad Venkatesulu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wineeta Melgandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Goura K Rath
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Supriya Mallick.

Ethics declarations

Funding

Nil

Conflict of interest

Nil

Meeting presentation

Not presented.

Financial support

No financial support received.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mallick, S., Benson, R., Venkatesulu, B. et al. Patterns of care and survival outcomes in patients with astroblastoma: an individual patient data analysis of 152 cases. Childs Nerv Syst 33, 1295–1302 (2017). https://doi.org/10.1007/s00381-017-3410-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-017-3410-5

Keywords

Search

Navigation