The evaluation of malignant astrocytoma score (MAS)

Abstract

Background/Aim. At the moment there are few scoring systems for malignant astrocytoma but they are not widely accepted. The aim of this study was to evaluate malignant astrocytoma score (MAS) on a new group of patients with malignant astrocytoma, to compare MAS with other prognostic tools and to describe the use of MAS in everyday practice in neurooncology. Methods. The study was performed on 124 patients with supratentorial malignant astrocytoma grade III or IV. They were operated on and subsequently irradiated with 50-60 Gy. Results. The mean age of the patients was 57.3 years. The mean Karnofski performance status (KPS) of the functional inpairment was 54. The removal of the tumor > 90% was done in 59.7% of patients. The mean survival was 9.1 months, and 27.4% of patients had a 12-month survival. The area under receiver operating characteristic (ROC) curve (AUC) of the MAS for predicting 6-, 12- and 18-month survival was 0.754, 0.783 and 0.882, respectively. We compared the MAS with the two mostly cited scoring systems. The AUC for the same prediction for medical research council (MRC) was 0.601, 0.693, 0.772 respectively. For the Radiation Therapy Oncology Group (RTOG) the AUC was 0.732, 0.765, 0.827, respectively. Conclusion. MAS represents a useful scoring system for determining illness severity and prognosis in patients with malignant supratentorial astrocytoma. It can be helpful in comparing single patients or groups of patients, as well as results of different treatments and in controlling the quality of hospital treatment and so on.Uvod/Cilj. Trenutno postoji nekoliko sistema za procenu malignih astrocitoma, ali oni nisu sire prihvaceni. Do sada su objavljeni sistemi: Medical Research Council (MRC), Radiation Therapy Oncology Group (RTOG) i Malignant Astrcytoma Score (MAS). Cilj ovoga rada bio je da se proceni sistem MAS, da se on uporedi sa drugim prognostickim metodama na novodijagnostikovanoj grupi bolesnika sa malignim astrocitomima velikog mozga, kao i da se opise upotreba MAS u svakodnevnoj klinickoj praksi. Metode. Ispitivanjem je bilo obuhvaceno 124 bolesnika sa malignim astrocitomom velikog mozga (gradus III i IV po World Health Organization - WHO). Oni su operisani i nakon toga leceni zracenjem dozom 50-60 Gy. Rezultati. Prosecna starost bolesnika bila je 57,3 god. Srednja vrednost indeksa Karnofskog bila je 54. Kod 59,7% slucajeva odstranjeno je vise od 90% tumora. Srednje prezivljavanje bolesnika bilo je 9,1 mesec, a vise od 12 meseci zivelo je 27,4% bolesnika. Vrednosti povrsine ispod krive ROC bile su za MAS procenu prezivljavanja od 6, 12 i 18 meseci, 0,754, 0,783 i 0,882, redom. Metoda ROC bila je za iste nacine predvidjanja za sistem MRC 0,601, 0,693 i 0,772, redom. Za sistem RTOG vrednost ROC bila je 0,732, 0,765 i 0,827, redom. Zakljucak. Smatramo da je MAS koristan sistem za procenu tezine bolesti i prognoze kod bolesnika koji boluju od supratentorijalnog malignog astrocitoma. On je koristan za uporedjivanje pojedinacnih bolesnika ili grupa izmedju sebe kao i za uporedjivanje rezultata razlicitih oblika lecenja, za kontrolu kvaliteta lecenja u pojedinim ustanovama i sl.