Cerebellar glioblastoma multiforme: a retrospective study of 28 patients at a single institution

Abstract

Cerebellar glioblastoma multiforme (CGBM) is rare and its treatment is ill defined. To elucidate prognostic factors, we performed a single institutional review of the largest series to date of CGBM. The West China Hospital database was reviewed from 2007 to June 2011, and a total of 28 CGBM patients were collected. Median age of patients was 50 years old, whereas median Karnofsky Performance Status was 80 (range, 30-100). Brainstem invasion was observed in 9 patients. Sixteen patients received total resection and 12 patients received subtotal resection. Postoperative Gamma Knife radiosurgery (GKRS) was administered to 22 patients. After operation, 16 patients received concurrent GKRS and chemotherapy, and 6 patients received chemotherapy after GKRS. In addition, 4 patients only received chemotherapy, and 2 patients did not receive either GKRS or chemotherapy due to various reasons. Median follow-up period was 13.7 months (range, 5.2-28.1 months). Median overall survival (OS) of 28 patients was 14.3 months and median progression-free survival (PFS) was 9.4 months. Univariate log-rank analysis showed that OS and PFS were significantly related to brainstem invasion (p = 0.03, p = 0.04, respectively), extent of resection (p = 0.02, p = 0.04, respectively) and GKRS (p = 0.01, p = 0.02, respectively) of GBM. Multivariate analysis revealed that OS and PFS were also significantly associated with brainstem invasion (p = 0.007, p = 0.014, respectively), extent of resection (p = 0.032, p = 0.045, respectively) and GKRS (p = 0.031, p = 0.046, respectively) of CGBM. According to our study, brainstem invasion, extent of resection and GKRS were major prognostic factors for survival. Combination of postoperative GKRS and chemotherapy had an improved prognosis, and it may be a feasible postoperative adjuvant treatment of CGBM.

Cerebellar anaplastic astrocytoma in adult patients: 15 consecutive cases from a single institution and literature review

“…Interestingly, the same correlation was absent for cerebellar glioblastomas: in a series of 202 cGB collected from SEER database and presented by Babu et al [2], OS for both cGB group and supratentorial GB (sGB) group was similar (7 months). Although Yang et al [34] presented a series of 28 cGB patients with much longer OS (14.3 months), their results must be taken with caution due to small-size sample. Multicenter study of cerebellar GBM conducted by Weber et al…”

“…However, no incidence of cAA has been reported due to its' utmost scarcity. This is not surprising that literature dealing with malignant gliomas of the cerebellum mostly consists of cerebellar glioblastomas, including both pediatric and adult patients, and brainstem tumours involving cerebellum [5,8,11,15,17,21,31,34].…”

Rapid Brainstem Infiltration of a Cerebellar Glioblastoma

“…Brainstem invasion in primary cerebellar glioblastoma is an adverse prognostic factor and is significantly detrimental to progression-free survival (PFS) and overall survival (OS) [ 5 , 6 , 8 ]. The presence of leptomeningeal disease in cerebellar glioblastoma results in markedly decreased OS and PFS as well [ 1 ].…”

“…Cerebellar glioblastoma is more frequently associated with neurofibromatosis type I [4]. Primary cerebellar glioblastoma with brainstem invasion occurs in 20-33% of the cases [5][6][7]. Although it is recognized that a cerebellar glioblastoma can infiltrate the brainstem, how rapidly this can be accomplished has been unreported.…”

Cerebellar anaplastic astrocytoma in adult patients: 15 consecutive cases from a single institution and literature review

“…Despite all those well-recognized facts, cAA cases pertain a better prognosis than supratentorial tumours of the same histological type. It is also true for cerebellar glioblastomas: Yang et al [33] presented a series of 28 cGB patients with OS 14.3 months. In a series of 202 cGB collected from SEER database and presented by Babu et al [2] OS both in cGB group and in supratentorial GB (sGB) group was similar (7 months).…”