High-grade astrocytomas: resource use, clinical outcomes, and cost of care

Mayo Clin Proc. 1996 Oct;71(10):936-44. doi: 10.1016/S0025-6196(11)63766-X.


Objective: To describe the clinical course, survival, resource use, and direct medical costs of care for patients with high-grade astrocytomas.

Material and methods: All patients with grade 3 or 4 astrocytoma who resided in Olmsted County, Minnesota, or one of the six adjacent counties and had a tissue diagnosis first made between 1987 and 1992 were studied. Clinical characteristics, initial management, use of resources, clinical course, survival, and medical charges were analyzed.

Results: Sixty-four patients, with a mean age of 62 years, were identified; 81% had glioblastoma multiforme. Approximately 60% underwent surgical resection, 80% had radiotherapy, and 50% had chemotherapy for initial management. After initial treatment (median duration, 116 days), approximately 75% of patients had a course with stable disease (median duration, 198 days). The overall median duration of survival was 323 days; lower grade and younger age were significantly associated with longer median survival-for example, 1,493 days for patients younger than 65 years with grade 3 astrocytomas and 205 days for patients 65 years old or older with grade 4 astrocytomas. The mean total direct medical charges were $67,887.

Conclusion: In most patients with high-grade astrocytomas, a substantial period elapsed before disease progressed. Although the overall median duration of survival was less than 1 year, younger patients, especially those with grade 3 astrocytomas, had a longer survival. The management of patients with high-grade astrocytomas uses substantial health-care resources.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Astrocytoma* / economics
  • Astrocytoma* / mortality
  • Astrocytoma* / therapy
  • Brain Neoplasms* / economics
  • Brain Neoplasms* / mortality
  • Brain Neoplasms* / therapy
  • Combined Modality Therapy
  • Costs and Cost Analysis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Analysis
  • Tomography, X-Ray Computed