Journal of Neuro-Oncology

, Volume 108, Issue 1, pp 187–193 | Cite as

Pilocytic astrocytoma survival in adults: analysis of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute

  • Derek R. Johnson
  • Paul D. Brown
  • Evanthia Galanis
  • Julie E. Hammack
Clinical Study


Pilocytic astrocytoma is a WHO grade 1 brain tumor common in children. Relatively little is known about the behavior of pilocytic astrocytomas in adult patients, largely due to the rarity of pilocytic astrocytoma in this population. Some data suggest that adults share the excellent prognosis seen in children, while other reports suggest more aggressive tumor behavior in adult patients. Patients diagnosed with pilocytic astrocytoma between 1973 and 2008 were identified in the National Cancer Institute Surveillance, Epidemiology, and End Results Program database. Age-group specific survival was analyzed with overall, expected, and cancer-specific survival rates. Further survival analyses were performed with the Kaplan–Meier method and Cox Proportional Hazards models. 3,066 patients with pilocytic astrocytoma were identified, including 865 patients aged 20 years and older. Survival rates declined significantly with age, from 96.5% 60-month survival in patients 5–19 years (95% CI 95.3–97.4) to 52.9% 60-month survival in adult patients 60+ years of age (95% CI 38.4–65.5), with a corresponding decrease in relative and cancer-specific survival rates. Gross total resection was a positive prognostic indicator in adults, while patients receiving radiation had shorter survival regardless of extent of resection. Pilocytic astrocytoma is associated with higher mortality in adult patients than in children and teens, and survival decreases with increasing age in adults. The morbidity of pilocytic astrocytoma in adults provides rationale for future trials of adjuvant treatment in high-risk patients.


Pilocytic astrocytoma Adult Mortality SEER program Survival 




Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC. 2012

Authors and Affiliations

  • Derek R. Johnson
    • 1
  • Paul D. Brown
    • 2
    • 3
  • Evanthia Galanis
    • 4
  • Julie E. Hammack
    • 1
  1. 1.Department of NeurologyMayo ClinicRochesterUSA
  2. 2.Department of Radiation OncologyMayo ClinicRochesterUSA
  3. 3.Department of Radiation OncologyM.D. Anderson Cancer CenterHoustonUSA
  4. 4.Department of OncologyMayo ClinicRochesterUSA

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