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Brain and Spinal Cord Tumors in Adults: Prognostic Factors

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For most types of cancer, the stage of the cancer – a measure of how far it has spread – is one of the most important factors in selecting treatment options and in determining a person's outlook (prognosis).

But tumors of the brain and spinal cord differ in some important ways from cancers in other parts of the body. One of the main reasons other cancers are dangerous is that they can spread throughout the body. Tumors starting in the brain or spinal cord can spread to other parts of the central nervous system, but they almost never spread to other organs. These tumors are dangerous because they can interfere with essential brain functions.

Because tumors in the brain or spinal cord almost never spread to other parts of the body, they do not have a formal staging system like most other cancers. Some of the important factors that help determine a person’s outlook include:

  • The person's age
  • Their functional level (whether the tumor is affecting normal brain functions and everyday activity)
  • The type of tumor (such as astrocytoma, ependymoma, etc.)
  • The grade of the tumor (how quickly the tumor is likely to grow, based on how the cells look under a microscope)
  • If the tumor cells have certain gene mutations or other changes (For example, tumors with a mutation in the IDH1 or IDH2 gene, known as “IDH-mutant” tumors, tend to grow more slowly and have a better outlook than tumors without these mutations.)
  • The location and size of the tumor
  • How much of the tumor can be removed by surgery (if it can be done)
  • Whether or not the tumor has spread through the cerebrospinal fluid to other parts of the brain or spinal cord
  • Whether or not tumor cells have spread beyond the central nervous system

If you have a brain or spinal cord tumor, talk to your doctor to learn more about how these and other factors might affect your outlook and treatment options.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.

Dorsey JF, Salinas RD, Dang M, et al. Chapter 63: Cancer of the central nervous system. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

National Cancer Institute Physician Data Query (PDQ). Adult Central Nervous System Tumors Treatment. 2020. Accessed at on February 11, 2020.

Wong ET, Wu JK. Overview of the clinical features and diagnosis of brain tumors in adults. UpToDate. Version 3.2019. Accessed at on February 11, 2020.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Central Nervous System Cancers. V.3.2019. Accessed at on February 13, 2020.

Last Revised: May 5, 2020

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