Prognosis and survival for brain and spinal cord tumours
If you have a brain or spinal cord tumour, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, grade and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for brain and spinal cord tumours.
Low-grade tumours have a better prognosis than high-grade tumours.
The type of brain or spinal cord tumour is an important prognostic factor. Some types of tumours have a better prognosis than others.
In general, people younger than 55 have a better prognosis.
Location and size of the tumour
The location and size of the tumour are important prognostic factors because they determine whether the tumour can be completely removed with surgery. Tumours that are small and easily accessible have a better prognosis.
Tumours that can be completely removed with surgery usually have a better prognosis.
If a tumour spreads to other areas of the central nervous system (CNS) or beyond the CNS, the prognosis is less favourable.
Performance status and neurological function
People with a high performance status (Karnofsky score of 70 or greater) before treatment have a better prognosis than those with a lower performance status. People who can carry out everyday activities, can walk and can take care of themselves have better neurological function and a higher performance status than those who require help or can’t do these activities.
Oligodendrogliomas have a chromosome abnormality where the “p” arm of chromosome 1 and the “q” arm of chromosome 19 have been deleted. These tumours are more responsive to chemotherapy and have a better prognosis than tumours that do not have this chromosome abnormality.
The measure of how well a person is able to perform ordinary tasks and carry out daily activities.
Examples of scales used to evaluate performance status include the Eastern Cooperative Oncology Group (ECOG), World Health Organization (WHO) and the Karnofsky performance status scale.
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The 5-year cancer survival rate has increased from 25% in the 1940s to 60% today.