1
|
Hong B, Lalk M, Wiese B, Merten R, Heissler HE, Raab P, Hartmann C, Krauss JK. Primary and secondary gliosarcoma: differences in treatment and outcome. Br J Neurosurg 2024; 38:332-339. [PMID: 33538191 DOI: 10.1080/02688697.2021.1872773] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/24/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION There are only few studies comparing differences in the outcome of primary versus secondary gliosarcoma. This study aimed to review the outcome and survival of patients with primary or secondary gliosarcoma following surgical resection and adjuvant treatment. The data were also matched with data of patients with primary and secondary glioblastoma (GBM). PATIENTS AND METHODS Treatment histories of 10 patients with primary gliosarcoma and 10 patients with secondary gliosarcoma were analysed and compared. Additionally, data of 20 patients with primary and 20 patients with secondary GBM were analysed and compared. All patients underwent surgical resection of the tumour in our department. Follow-up data, progression-free survival (PFS), and median overall survival (mOS) were evaluated. RESULTS The median PFS in patients with primary gliosarcoma was significantly higher than in patients with secondary gliosarcoma (p = 0.037). The 6-month PFS rates were 80.0% in patients with primary and 30.0% in patients with secondary gliosarcoma. Upon recurrence, five patients with primary gliosarcoma and four patients with secondary gliosarcoma underwent repeat surgical resection. The mOS of patients with primary gliosarcoma was significantly higher than that of patients with secondary gliosarcoma (p = 0.031). The percentage of patients surviving at 1-year/2-year follow-up in primary gliosarcoma was 70%/20%, while it was only 10%/10% in secondary gliosarcoma. When PFS and mOS of primary gliosarcoma was compared to primary GBM, there were no statistically differences (p = 0.509; p = 0.435). The PFS and mOS of secondary gliosarcoma and secondary GBM were also comparable (p = 0.290 and p = 0.390). CONCLUSION Patients with primary gliosarcoma have a higher PFS and mOS compared to those with secondary gliosarcoma. In the case of tumour recurrence, patients with secondary gliosarcoma harbour an unfavourable prognosis with limited further options. The outcome of patients with primary or secondary gliosarcoma is comparable to that of patients with primary or secondary GBM.
Collapse
Affiliation(s)
- Bujung Hong
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
- Department of Neurosurgery, Brandenburg Medical School, Helios Medical Center, Bad Saarow, Germany
| | - Michael Lalk
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Bettina Wiese
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Roland Merten
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
| | - Hans E Heissler
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Peter Raab
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Christian Hartmann
- Department for Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| |
Collapse
|
2
|
Ferreyra Vega S, Olsson Bontell T, Kling T, Jakola AS, Carén H. Longitudinal DNA methylation analysis of adult-type IDH-mutant gliomas. Acta Neuropathol Commun 2023; 11:23. [PMID: 36739454 PMCID: PMC9899392 DOI: 10.1186/s40478-023-01520-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/24/2023] [Indexed: 02/06/2023] Open
Abstract
Diffuse gliomas are the most prevalent malignant primary brain tumors in adults and remain incurable despite standard therapy. Tumor recurrence is currently inevitable, which contributes to a persistent high morbidity and mortality in these patients. In this study, we examined the genome-wide DNA methylation profiles of primary and recurrent adult-type IDH-mutant gliomas to elucidate DNA methylation changes associated with tumor progression (with or without malignant transformation). We analyzed DNA methylation profiles of 37 primary IDH-mutant gliomas and 42 paired recurrences using the DNA methylation EPIC beadChip array. DNA methylation-based classification reflected the tumor progression over time. We observed a methylation subtype switch in a proportion of IDH-mutant astrocytomas; the primary tumors were subclassified as low-grade astrocytomas, which progressed to high-grade astrocytomas in the recurrent tumors. The CNS WHO grade 4 IDH-mutant astrocytomas did not always resemble methylation subclasses of higher grades. The number of differentially methylated CpG sites increased over time, and astrocytomas accumulated more differentially methylated CpG sites than oligodendrogliomas during tumor progression. Few differentially methylated CpG sites were shared between patients. We demonstrated that DNA methylation profiles are mostly maintained during IDH-mutant glioma progression, but CpG site-specific methylation alterations can occur.
Collapse
Affiliation(s)
- Sandra Ferreyra Vega
- grid.8761.80000 0000 9919 9582Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 7, 413 45 Gothenburg, Sweden ,grid.8761.80000 0000 9919 9582Sahlgrenska Center for Cancer Research, Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Olsson Bontell
- grid.8761.80000 0000 9919 9582Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ,grid.1649.a000000009445082XDepartment of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Teresia Kling
- grid.8761.80000 0000 9919 9582Sahlgrenska Center for Cancer Research, Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Asgeir Store Jakola
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 7, 413 45, Gothenburg, Sweden. .,Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden. .,Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.
| | - Helena Carén
- Sahlgrenska Center for Cancer Research, Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| |
Collapse
|
3
|
Liu J, Li C, Wang Y, Ji P, Guo S, Zhai Y, Wang N, Xu M, Wang J, Wang L. Prognostic and predictive factors of secondary gliosarcoma: A single-institution series of 18 cases combined with 89 cases from literature. Front Oncol 2023; 12:1026747. [PMID: 36798692 PMCID: PMC9927223 DOI: 10.3389/fonc.2022.1026747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/27/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Secondary gliosarcomas (SGS) are rare malignancies that are diagnosed subsequent to pre-existing glioma. Clinical features and optimal treatment strategies for SGS have not been conclusively established. This study aimed to assess the clinicopathological features and outcomes of SGS. Methods We assessed the clinicopathological features and outcomes of SGS via retrospective analysis of data for SGS patients at Tangdu Hospital. Data from SGS patients in prior publications were also analyzed in accordance with PRISMA guidelines. Results Eighteen SGS patients who had been treated at Tangdu Hospital between 2013 and 2020 were enrolled in this study. Additional 89 eligible SGS patients were identified from 39 studies. The median age for the patients was 53 years old, and the most common location was the temporal lobe. The most common initial diagnosis was glioblastoma (GBM) (72.0%). Radiology revealed enhanced masses in 94.8% (73/77) of patients. Ten patients (10/107, 9.35%) had extracranial metastases at or after SGS diagnosis. Patients with initial diagnosis of non-GBM and who were younger than 60 years of age were significantly associated with a long duration of disease progression to SGS. After SGS diagnosis, patients with initial non-GBM diagnosis, gross total resection and chemoradiotherapy exhibited prolonged survival outcomes. Patients who had been initially diagnosed with GBM and received both chemoradiotherapy and active therapy after disease progression to SGS, had a significantly longer overall survival than patients who did not. Conclusion Initial diagnosis of GBM was a poor prognostic factor for SGS. Patients who underwent gross total resection and chemoradiation had better overall survival outcomes than those who did not. However, during treatment, clinicians should be cognizant of possible extracranial metastases.
Collapse
Affiliation(s)
- Jinghui Liu
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Chen Li
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Yuan Wang
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Peigang Ji
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Shaochun Guo
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Yulong Zhai
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Na Wang
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Meng Xu
- Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China
| | - Julei Wang
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China,*Correspondence: Julei Wang, ; Liang Wang,
| | - Liang Wang
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China,Innovation Center for Advanced Medicine, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China,*Correspondence: Julei Wang, ; Liang Wang,
| |
Collapse
|
4
|
Huang Q, Li F, Chen Y, Hong F, Wang H, Chen J. Prognostic factors and clinical outcomes in adult primary gliosarcoma patients: a Surveillance, Epidemiology, and End Results (SEER) analysis from 2004 to 2015. Br J Neurosurg 2019; 34:161-167. [PMID: 31829033 DOI: 10.1080/02688697.2019.1699903] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Gliosarcoma (GSC), a rare malignant brain tumor, is considered as a variant of isocitrate dehydrogenase 1 wild type (IDH1-WT) glioblastoma (GBM). This study aimed to retrospectively analyze the clinical characteristics of GSC and compare whether there are some differences of treatment strategies and outcomes between GSC and GBM patients through Surveillance, Epidemiology, and End Results (SEER) database.Patients and methods: The clinical data of adults diagnosed with primary GSC between 2004 and 2015 were queried from SEER database. The Kaplan-Meier curve and the Cox model were performed to analyze the relationships between clinical parameters and patients' prognosis. Similar analyses were conducted for all primary GBM patients of SEER.Results: In total, 527 GSC and 20,541 GBM patients with complete and valid clinical information were finally enrolled for further analysis. Compared with GBM, GSC owned a proclivity to temporal lobe rather than frontal lobe (p < 0.001), a less conservative extension of resection (EOR) (p < 0.001), and a higher sensitivity to radiotherapy (p < 0.001). As shown by univariate analysis, surgery, radiotherapy and chemotherapy could prolong the overall survival (OS) time of GSC, but EOR did not confer an advantage to the outcomes of patients, no matter whether combined radio/chemotherapy was given. In multivariate analysis, age more than 60 and lack of radio/chemotherapy were identified as independent risk factors for OS of GSC patients.Conclusions: Our study found that although EOR seemed to be important to GBM, the extent of surgery did not show a clear relationship with the improved prognosis of GSC. Additionally, radiotherapy and chemotherapy could prolong patients' survival time significantly, which suggests a more positive role of them in treating GSC and needs further investigations.
Collapse
Affiliation(s)
- Qilin Huang
- Department of Neurosurgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.,Department of Neurosurgery, General Hospital of Central Theater Command of Chinese People's Liberation Army, Wuhan, China
| | - Feng Li
- Department of Neurosurgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.,Department of Orthopaedics, The 943rd Hospital of Joint Logistic Support Force of PLA, Wuwei, China
| | - Yihong Chen
- Department of Cardiology, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Fan Hong
- Department of Neurosurgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Hongxiang Wang
- Department of Neurosurgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Juxiang Chen
- Department of Neurosurgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| |
Collapse
|
5
|
Tanaka S, Hitotsumatsu T, Sugita Y, Ishido K, Ito O, Hatae R, Akagi Y, Yoshimoto K, Iihara K. Gliosarcoma arising from oligodendroglioma (Oligosarcoma): A case report with genetic analyses. Pathol Int 2018; 68:567-573. [DOI: 10.1111/pin.12723] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 08/29/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Shunya Tanaka
- Department of Neurosurgery; Stroke and Neurological Center; Shin-Koga Hospital Kurume Japan
| | - Tsutomu Hitotsumatsu
- Department of Neurosurgery; Stroke and Neurological Center; Shin-Koga Hospital Kurume Japan
| | - Yasuo Sugita
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Katsuya Ishido
- Department of Neurosurgery; Stroke and Neurological Center; Shin-Koga Hospital Kurume Japan
| | - Osamu Ito
- Department of Neurosurgery; Stroke and Neurological Center; Shin-Koga Hospital Kurume Japan
| | - Ryusuke Hatae
- Department of Neurosurgery; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Yojiro Akagi
- Department of Neurosurgery; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Koji Yoshimoto
- Department of Neurosurgery; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Koji Iihara
- Department of Neurosurgery; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| |
Collapse
|