Prognosis:

About 13,000 people die from cancerous brain tumors each year. Recent advances in surgical and radiation treatments have significantly extended average survival times and can reduce the size and progression of malignant gliomas.

The survival rates in people with brain tumors depend on many different variables:

• Type of tumor (such as astrocytoma, oligodendroglioma, or ependymoma)
• Location and size of tumor (these factors affect whether the tumor can be removed surgically or not)
• Tumor grade
• Patient's age
• Patient's ability to function
• How far the tumor has spread

Grading Tumors

Malignant primary brain tumors are classified according to tumor grade. Grade I is the least cancerous, and Grades IV and V are the most dangerous. Grading a tumor can help predict its growth rate and tendency to spread. Grading is based on the appearance of the tumor cells as seen under a microscope.

• Lower-grade (I and II) tumor cells are well defined and almost normal-shaped. (Some primary low-grade brain tumors are curable by surgery alone, and some are curable by surgery and radiotherapy. Low-grade tumors tend to have the most favorable survival rates and high-grade the least. However, this is not always the case. For example, some low-grade II gliomas are at very high risk for progression.)
• Higher-grade (III and IV) tumor cells are abnormally shaped and are more diffuse, which indicates more aggressive behavior. (High-grade brain tumors usually require surgery, radiotherapy, chemotherapy, and possibly investigational treatments.)

In tumors that contain a mixture of different-grade cells, the tumor is graded using the highest-grade cells in the mixture, even when there are very few of them.

Survival Rates

Survival rates for brain tumors vary widely depending on the type of tumor and other factors, including age. Survival rates tend to be highest for younger patients and decrease with age. Five-year survival rates range from 66% for children ages 0 - 19 years to 5% for adults age 75 years and older.

Patients with some types of tumors have relatively good survival rates. Five year survival rates for patients with ependymoma and oligodendroglioma are, respectively, 85% and 81% for people ages 20 - 44, and 69% and 45% for patients ages 55 - 64. Glioblastoma multiforme has the worst prognosis with 5-year survival rates of only 13% for people ages 20 - 44, and 1% patients age 55 - 64.

Specific Effects of Tumors on Function

The specific effects of tumors on the brain can cause seizures, mental changes, and mood, personality, and emotional changes. Tumors may also impair muscle usage in certain body areas, hearing, vision, speech, and other neurologic complications. Such effects can be devastating to the patient and the caregivers. Numerous treatments are available that help alleviate these complications, and patients and family members should discuss these options with their doctors.

Effects in Children. Advancements in treatment have dramatically increased survival rates for children with brain tumors. About 75% of children survive at least 5 years after being diagnosed with a brain tumor. Unfortunately, many childhood brain tumor survivors are at risk for long-term neurological complications. Neurocognitive impairment may result from the tumor and from treatment (cranial radiation therapy, chemotherapy that penetrates the blood-brain barrier).

Children younger than age 7 (and particularly those younger than age 3 years) appear to have the greatest risk for cognitive problems. These long-term problems include difficulties with attention and concentration, memory, mental processing of information, visual perception skills, and problems with planning, insight, initiative, and organizational competencies. Parents need to make sure that children receive appropriate supportive services and educational accommodation at their schools.