Clinical Characteristics and Outcomes for a Modern Series of Primary Gliosarcoma Patients

被引:70
作者
Han, Seunggu J. [1 ]
Yang, Isaac [1 ]
Ahn, Brian J. [1 ]
Otero, Jose J. [2 ]
Tihan, Tarik [2 ]
McDermott, Michael W. [1 ]
Berger, Mitchel S. [1 ]
Prados, Michael D. [1 ]
Parsa, Andrew T. [1 ]
机构
[1] Univ San Francisco, Dept Neurol Surg, San Francisco, CA 94117 USA
[2] Univ Calif San Francisco, Dept Pathol, San Francisco, CA USA
关键词
gliosarcoma; primary gliosarcoma; clinical subtype; clinical outcome; treatment modalities; CEREBRAL GLIOSARCOMA; GLIOBLASTOMA-MULTIFORME; METASTASES; DIFFERENTIATION; FIBROSARCOMA; FEATURES; SARCOMA; BRAIN; TUMOR;
D O I
10.1002/cncr.24857
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: Primary gliosarcoma (PGS) is a rare central nervous system tumor with limited experience reported in the literature. In the current study, the authors present a modern series of confirmed PGS cases treated in the era of magnetic resonance imaging (MRI), after the accepted glioblastoma management of resection, radiation, and temozolomide. METHODS: Using a retrospective review, patients with confirmed PGS were identified (1996-2008). Cases were determined to be PGS by central pathology review using the 2007 World Health Organization criteria. Extensive chart review was performed to gather clinical and pathologic data on these cases. RESULTS: All but I patient had undergone a preoperative MRI, with I patient receiving a computed tomography scan due to a cardiac pacemaker. A total of 10 patients received radiotherapy with concurrent and adjuvant temozolomide chemotherapy, and 8 patients received radiotherapy alone or in combination with other chemotherapeutic agents. In 2 patients, the history of adjuvant treatment could not be confirmed. The overall median survival was 13.9 months (range, 2.2-22.9 months). Patients with gliosarcomas resembling meningioma were found to have a significantly prolonged median survival compared with patients harboring gliosarcoma resembling glioblastoma multiforme (16 months vs 9.6 months; P =.011). However, no difference in survival was noted between patients who received concurrent radiotherapy and temozolomide compared with those who did not (10.4 months vs 13.9 months; P =.946). CONCLUSIONS: The results of the current study support previous hypotheses that there are 2 distinct types of PGS. The type mimicking the appearance of a meningioma appears to carry a significantly more favorable prognosis, most likely due to an increased chance at achieving macroscopic total resection. Cancer 2010;116:1358-66. (C) 2070 American Cancer Society.
引用
收藏
页码:1358 / 1366
页数:9
相关论文
共 35 条
[1]   Comprehensive analysis of genomic alterations in gliosarcoma and its two tissue components [J].
Actor, B ;
Cobbers, JMJL ;
Büschges, R ;
Wolter, M ;
Knobbe, CB ;
Lichter, P ;
Reifenberger, G ;
Weber, RG .
GENES CHROMOSOMES & CANCER, 2002, 34 (04) :416-427
[2]   Gliosarcoma with multiple extracranial metastases: case report and review of the literature [J].
Beaumont, Thomas L. ;
Kupsky, William J. ;
Barger, Geoffrey R. ;
Sloan, Andrew E. .
JOURNAL OF NEURO-ONCOLOGY, 2007, 83 (01) :39-46
[3]   IDENTICAL MUTATIONS OF THE P53 TUMOR-SUPPRESSOR GENE IN THE GLIOMATOUS AND THE SARCOMATOUS COMPONENTS OF GLIOSARCOMAS SUGGEST A COMMON ORIGIN FROM GLIAL-CELLS [J].
BIERNAT, W ;
AGUZZI, A ;
SURE, U ;
GRANT, JW ;
KLEIHUES, P ;
HEGI, ME .
JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL NEUROLOGY, 1995, 54 (05) :651-656
[4]   EXTRANEURAL METASTASES IN GLIOSARCOMA - A CASE-REPORT AND REVIEW OF THE LITERATURE [J].
CERAME, MA ;
GUTHIKONDA, M ;
KOHLI, CM .
NEUROSURGERY, 1985, 17 (03) :413-418
[5]   Cerebral gliosarcoma: Prognostic factors [J].
Cervoni, L ;
Celli, P .
NEUROSURGICAL REVIEW, 1996, 19 (02) :93-96
[6]  
EHRENREICH T, 1958, ARCH PATHOL, V66, P536
[7]  
FEIGIN IH, 1955, AM J PATHOL, V31, P633
[8]   Clinical outcome of gliosarcoma compared with glioblastoma multiforme: North Central Cancer Treatment Group results [J].
Galanis, E ;
Buckner, JC ;
Dinapoli, RP ;
Scheithauer, BW ;
Jenkins, RB ;
Wang, CH ;
O'Fallon, JR ;
Farr, G .
JOURNAL OF NEUROSURGERY, 1998, 89 (03) :425-430
[9]  
GARRET R, 1958, CANCER-AM CANCER SOC, V11, P888, DOI 10.1002/1097-0142(195809/10)11:5<888::AID-CNCR2820110504>3.0.CO
[10]  
2-T