Abstract
It is unclear how the diagnosis of a second cancer influences the treatment and complications of patients with astrocytoma. A chart review of patients with astrocytoma and a second systemic cancer was performed to understand the possible complications that a systemic cancer diagnosis might bring to the treatment of the patient. Inclusion criteria was the histological diagnosis of diffuse or anaplastic astrocytoma and another non-skin systemic cancer. Exclusion criteria was the diagnosis of any genetic syndrome that predisposes tumorigenesis. A total of 17 patients were identified. The most common systemic cancer was thyroid (22) followed by colon and breast cancer (each one 17%). Men were 59% of the patients (p= 0.38), but older (60 +14 years, p=0.003) when compared to CBTRUS data. Systemic cancer was diagnosed before astrocytoma in 61% of the cases. Age at the diagnosis of systemic cancer was 48 +14 years. Only 9% of the patients who had systemic cancer before astrocytomas survived 5 years, what is less than expected when compared with literature, (p=0.02). Those also survived less than the patients that had systemic cancer after the diagnosis of astrocytomas (8.1+6.4 years). Thromboembolism was seen in 12.5% (p=0.8), always after the astrocytoma diagnosis. Thrombocytopenia was not related to prior chemotherapy. In patients with systemic cancer diagnosed while on treatment for astrocytoma, a delay or shortened course of the treatment was seen in rare cases, and one patient had their course of treatment for astrocytoma shortened. The conclusion of this chart review of patients with the diagnosis of astrocytoma and a systemic cancer identifies that this population is older than expected and the diagnosis of systemic cancer before astrocytoma might predict a shorter survival.