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Ius T, Montemurro N, Lombardi G, Berardinelli J, Romano A, Barresi V, Cerretti G, Guarnera A, Tel A, Cavallo LM, Pasqualetti F, Feletti A. Decoding the puzzle: A multidisciplinary systematic review of adult brainstem glioma. Crit Rev Oncol Hematol 2024; 196:104261. [PMID: 38395241 DOI: 10.1016/j.critrevonc.2024.104261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/26/2023] [Accepted: 01/04/2024] [Indexed: 02/25/2024] Open
Abstract
Adult brainstem gliomas (BSGs) are a group of rare central nervous system tumors with varying prognoses and controversial standard treatment strategies. To provide an overview of current trends, a systematic review using the PRISMA guidelines, Class of evidence (CE) and strength of recommendation (SR), was conducted. The review identified 27 studies. Surgery was found to have a positive impact on survival, particularly for focal lesions with CE II SR C. Stereotactic image-guided biopsy was recommended when resective surgery was not feasible with CE II and SR B. The role of systemic treatments remains unclear. Eight studies provided molecular biology data. This review gathers crucial literature on diagnosis and management of adult BSGs. It provides evidence-based guidance with updated recommendations for diagnosing and treating, taking into account recent molecular and genetic advancements. The importance of brain biopsy is emphasized to optimize treatment using emerging genetic-molecular findings and explore potential targeted therapies.
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Affiliation(s)
- Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department University Hospital of Udine, Italy.
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Jacopo Berardinelli
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Andrea Romano
- Department of Neuroradiology, NESMOS S. Andrea Hospital, University Sapienza, Rome, Italy
| | - Valeria Barresi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giulia Cerretti
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Alessia Guarnera
- Department of Neuroradiology, NESMOS S. Andrea Hospital, University Sapienza, Rome, Italy
| | - Alessandro Tel
- Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department University Hospital of Udine, Italy
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Francesco Pasqualetti
- Division of Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Alberto Feletti
- Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, Italy
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Vats P, Arvind P, Sarin A, Singh S, Sandhu M. A decade of treating brain stem gliomas: Single institutional experience. J Cancer Res Ther 2023:01363817-990000000-00027. [PMID: 38102910 DOI: 10.4103/jcrt.jcrt_2522_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/13/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Brainstem is a rare yet challenging site for primary brain tumors. We present the patient characteristics, treatment-related details, and survival outcomes of patients with brain stem gliomas treated over a decade, from August 2010 to July 2022, at a tertiary care center in northern India. MATERIALS AND METHODS Twenty-seven patients of brainstem gliomas were treated in our hospital from August 2010 to July 2022. All of these patients were treated with radiation therapy based on a radiological diagnosis only. Data were collected and analyzed from patient registration, treatment, and follow-up records. RESULTS Of the 27 patients, 18 were male and 9 were female. Fourteen patients (51.85%) were in the pediatric age group (<12 years). The most common symptom at onset was hemiparesis, seen in 62.96%. The majority of the patients (24; 88.88%) had pontine involvement at the time of treatment. Overall survival at a minimum 2-year follow-up post-treatment was 22.22% in the entire cohort. Age, sex, or size of tumor at presentation was not seen to have any significant impact on survival of patients. CONCLUSION With the advancement in surgical techniques and molecular analysis of brain tumors, there is likely to be a change in the management of brainstem gliomas; however, radiation therapy has been used for the management of these tumors for decades now. Radiation therapy continues to show rapid and significant radiological and clinical improvement in the majority of such patients, and it would continue to play an important part in multi-modality management.
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Affiliation(s)
- Pankaj Vats
- Department of Radiation Oncology, Army Hospital (R and R), New Delhi, India
| | - Prince Arvind
- Department of Radiation Oncology, Army Hospital (R and R), New Delhi, India
| | - Arti Sarin
- Department of Radiation Oncology and Radiology, Director and Commandant, Armed Forces Medical College, Pune, Maharashtra, India
| | - Sankalp Singh
- Department of Radiation Oncology, Army Hospital (R and R), New Delhi, India
| | - Manish Sandhu
- Department of Radiation Oncology, Army Hospital (R and R), New Delhi, India
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Ius T, Lombardi G, Baiano C, Berardinelli J, Romano A, Montemurro N, Cavallo LM, Pasqualetti F, Feletti A. Surgical Management of Adult Brainstem Gliomas: A Systematic Review and Meta-Analysis. Curr Oncol 2023; 30:9772-9785. [PMID: 37999129 PMCID: PMC10670486 DOI: 10.3390/curroncol30110709] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023] Open
Abstract
The present review aims to investigate the survival and functional outcomes in adult high-grade brainstem gliomas (BGSs) by comparing data from resective surgery and biopsy. MEDLINE, EMBASE and Cochrane Library were screened to conduct a systematic review of the literature, according to the PRISMA statement. Analysis was limited to articles including patients older than 18 years of age and those published from 1990 to September 2022. Case reports, review articles, meta-analyses, abstracts, reports of aggregated data, and reports on multimodal therapy where surgery was not the primary treatment were excluded. The ROBINS-I tool was applied to evaluate the risk of bias. Six studies were ultimately considered for the meta-analysis. The resective group was composed of 213 subjects and the bioptic group comprised 125. The analysis demonstrated a survival benefit in those patients in which an extensive resection was possible (STR HR 0.59 (95% CI 0.42, 0.82)) (GTR HR 0.63 (95% CI 0.43, 0.92)). Although surgical resection is associated with increased survival, the significantly higher complication rate makes it difficult to recommend surgery instead of biopsy for BSGs. Future investigations combining volumetric data and molecular profiles could add important data to better define the proper indication between resection and biopsy.
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Affiliation(s)
- Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, 33100 Udine, Italy;
| | - Giuseppe Lombardi
- Department of Oncology 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy;
| | - Cinzia Baiano
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, 80131 Naples, Italy; (C.B.); (L.M.C.)
| | - Jacopo Berardinelli
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, 80131 Naples, Italy; (C.B.); (L.M.C.)
| | - Andrea Romano
- Department of Neuroradiology, NESMOS S.Andrea Hospital, University Sapienza, 00189 Rome, Italy;
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy;
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, 80131 Naples, Italy; (C.B.); (L.M.C.)
| | | | - Alberto Feletti
- Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, 37129 Verona, Italy;
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He A, Xu L, Yang X, Gu Z, Cai Y, Zhou H. Risk factors for surgical compliance and impact on the survival of patients with glioma: a population-based propensity score-matched study. J Cancer Res Clin Oncol 2023; 149:14797-14815. [PMID: 37589923 DOI: 10.1007/s00432-023-05261-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE To comprehensively analyze the impact of surgical compliance on the survival of patients with glioma and to explore the factors that influence surgical compliance. METHODS Clinical data of patients with glioma between 2004 and 2018 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves and Cox regression were used to analyze the effect of surgical compliance on overall survival (OS) and disease-specific survival (DSS). Multivariate Cox regression was used to select the prediction variables and construct the nomograms. The predictive power of these models was assessed using Harell's consistency index (C-index), decision curve analysis (DCA), receiver operating characteristic (ROC) curves, and calibration curves. Multivariate logistic regression was performed to analyze the related variables of surgical compliance, and 1:1 propensity score matching (PSM) was applied to evaluate the validity of the results of patients with favorable and poor surgical compliance. RESULTS Among the 47,573 eligible glioma patients recommended for surgery, 46,380 (97.5%) were in the surgical compliance group, while 1193 (2.5%) were in the noncompliance group. Surgical compliance was an independent prognostic factor for glioma patients, as indicated by multivariate Cox regression analysis that patients with surgical compliance had worse OS (hazard ratio [HR] 1.924; 95% confidence interval [CI] 1.800-2.056, p < 0.001) and DSS (HR 1.718; 95% CI 1.592-1.853, p < 0.001) in comparison to those without surgical compliance. A nomogram was developed and internally validated to be able to predict glioma prognosis. The nomogram can well predict patients' OS (C-index: 0.745) and DSS (C-index: 0.744). ROC curve, DCA curve, and calibration curve were applied to further assess the accuracy of the nomogram. Poor surgical compliance was found to be related to older age, female gender, tumor diameter, grade II or higher, poor grading, tumor location in the cerebellum and brainstem, and low household income. CONCLUSION Surgical compliance is an independent prognostic factor for predicting the OS and DSS of patients with glioma, and good surgical compliance was significantly related to good survival.
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Affiliation(s)
- Aifeng He
- Emergency Department, Binhai County People's Hospital, Yancheng, China
| | - Leiming Xu
- Emergency Department, Binhai County People's Hospital, Yancheng, China
| | - Xudong Yang
- Neurosurgery, Binhai County People's Hospital, Yancheng, China
| | - Zhou Gu
- Oncology Department, Binhai County People's Hospital, Yancheng, China
| | - Yong Cai
- Department of Neurology, Binhai County People's Hospital, Yancheng, China
| | - Hai Zhou
- Neurosurgery, Binhai County People's Hospital, Yancheng, China.
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Zhang D, Li H, Jia W. Exploration of the prognostic value of the resection of adult brainstem high-grade glioma based on competing risk model, propensity score matching, and conditional survival rate. Neurol Sci 2023; 44:1755-1764. [PMID: 36604383 PMCID: PMC10102064 DOI: 10.1007/s10072-022-06557-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/10/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Adult brainstem high-grade glioma (HGG) is a refractory disease, and the treatment strategy of resection is still controversial. OBJECTIVE To investigate the prognostic value of brainstem HGG resection in adults. METHODS We collected 126,386 samples from the Surveillance, Epidemiology, and End Results (SEER) database between 1998 and 2016, and screened 973 patients diagnosed with adult brainstem HGG, who were in turn, grouped into 899 cases of non-resections and 74 cases of resections. Competing risk models were used to screen independent prognostic factors. Propensity score matching (PSM) was performed to reduce the influence of confounding factors. Conditional survival (CS) rate was considered to evaluate the changes in overall survival (OS) and disease-specific survival (DSS) of patients with HGG over time. RESULTS Based on the competing risk model and PSM, univariate analysis showed that age ≥ 45 years and male gender were poor prognostic factors for adult brainstem HGG. No previous history of glioma was a beneficial factor. Multivariate analysis revealed only the absence of a history of glioma to be a favorable prognostic factor. Considering the CS rate of the resection group, after the patient had survived for 3 years, the OS and DSS remained unchanged at 100% during the fourth and fifth years, whereas in the non-resection group, the OS and DSS of the patients were 82% and 74%, respectively. CONCLUSION Adult brainstem HGG resection has a poor prognosis in the early stage; however, patients have a potentially significant survival benefit after 3 years of survival.
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Affiliation(s)
- Dainan Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Haiming Li
- Henan Provincial Key Laboratory of Neurorestoratology, The First Affiliated Hospital of Xinxiang Medical University, Wei Hui, China
| | - Wang Jia
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China. .,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
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Li D, Peng J, Ran J. LINC01094 Affects Glioma Cell Proliferation Through miR-204-3p. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.3198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study intends to assess LINC01094′s role in glioma cells. LINC01094 level in glioma tissue was detected by RT qPCR. After transfection of LINC01094 overexpression plasmid, LINC01094 siRNA, and si-LINC01094 and miR-204-3p inhibitor, cell proliferation was evaluated by MTT
and cell invasion and migration was assessed by transwell and scratch test. LINC01094 expression in glioma tissues was significantly increased. Overexpression of LINC01094 can significantly promote cell proliferation, which was significantly inhibited after knockdown of LINC01094. In addition,
silence of LINC01094 can upregulate miR-204-3p and inhibit cell proliferation and promote apoptosis induced by overexpression of LINC01094. In conclusion, LINC01094 promotes glioma cell proliferation through miR-204-3p.
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Affiliation(s)
- Daokun Li
- The Molecular Medicine Center, Department of Medicine, Hubei University of Arts and Science, Xiangyang, 441053, Hubei, China
| | - Juan Peng
- Department of Blood Transfusion, Affiliated Taihe Department of Hospital of Hubei University of Blood Medicine, Shiyan, 430050, Hubei, China
| | - Jian Ran
- Department of Neurosurgery, People’s Hospital of Wulong District, Chongqing, 408500, China
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