Prognostic Factors and Treatment of Spinal Astrocytomas

A Multi-institutional Cohort Analysis

Yingjie Zou, MD; James Sun, BA; Yangying Zhou, BS; Harrison Xiao Bai, MD; Xiangyan Huang, MD; Ranjith Babu, MD; Alessandro Landi, MD; Kap Sum Foong, MD; Zishu Zhang, MD; John H. Woo, MD; Yongguang Tao, PhD; Xuejun Li, MD, PhD; Xiangqi Tang, MD, PhD; Bo Xiao, MD, PhD; Paul J. Zhang, MD; Li Yang, MD, PhD


Spine. 2018;43(10):E565-E573. 

In This Article


We would like to acknowledge several limitations of our study. First, the multi-institutional cohort meant variation in patient demographics and treatment protocols. However, all four institutions included were large referral centers. Second, in the literature cohort, there was a higher proportion of high-grade tumors than low-grade tumors which may reflect publication bias. Third, there was unavoidable selection bias by including such a heterogeneous population from the literature, since treatments such as RT and chemotherapy may not have been given randomly. Fourth, some of the reports in our analysis come from the pre-magnetic resonance imaging era, where there was no central review of the extent of resection. Finally, attention has recently been paid to the molecular status of astrocytoma, such as the status of isocitrate dehydrogenase mutation. Because of the lack of molecular information for patients collected from the four institutions and the vast majority of the published articles, our analysis did not include this information.