Prognosis and survival for brain and spinal cord tumours

A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors.

The doctor will look at certain aspects of the cancer as well as characteristics of the person (such as age). These are called prognostic factors. The doctor will also look at predictive factors, which influence how a cancer will respond to a certain treatment and how likely it is that the cancer will come back after treatment.

Prognostic and predictive factors are often discussed together. They both play a part in deciding on a prognosis and a treatment plan just for you. Only a doctor familiar with your medical history, the type and stage of the cancer, the molecular and genetic changes in the cancer cells, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis and chances of survival.

The following are prognostic and predictive factors for brain and spinal cord tumours.

Grade 1 or 2 tumours (low grade) have a better prognosis than grade 3 or 4 tumours (high grade).

Some types of tumours respond better to treatment than others. Other types of brain and spinal cord tumours spread deeply into the surrounding tissues, which makes them difficult to remove completely during surgery.

Biomarkers found in a brain or spinal cord tumour can predict how it will behave or if it will respond to certain types of treatment. Tumours with certain genetic alterations (changes) may respond better to chemotherapy and targeted therapy than tumours that don’t have these changes.

In general, people younger than 55 have a better prognosis.

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 (2 cm or smaller) and can be easily reached during surgery have a better prognosis.

Tumours that can be completely removed with surgery usually have a better prognosis than those that can’t be removed.

In rare cases, some types of brain and spinal cord tumours can spread to the cerebrospinal fluid (CSF). If this happens, the prognosis is less favourable.

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 walk, carry out everyday activities and take care of themselves have better neurological function and a higher performance status than those who require help or can’t do these activities.

People who have problems with neurological functions (such as speech and language problems, reasoning difficulties or personality changes) when they are first diagnosed have a poor prognosis.