Chasing a rarity: a retrospective single-center evaluation of prognostic factors in primary gliosarcoma

Dejonckheere, Cas Stefaan; Böhner, Alexander; Koch, David; Schmeel, Leonard Christopher; Herrlinger, Ulrich; Vatter, Hartmut; Schneider, Matthias; Schuss, Patrick; Giordano, Frank A.; Köksal, Mümtaz

doi:10.1007/s00066-021-01884-0

“…The situation is generally consistent with the previous research results [17][18][19][20][21][22]. In our cohort, the proportion of patients with secondary GSM is 17.8%, which is still consistent with existing reports [22,23].…”

Section: Discussionsupporting

confidence: 93%

Prognostic Factors of Gliosarcoma in the Real World: A Retrospective Cohort Study

Hu

¹

,

Yu

²

,

Zhou

³

et al. 2022

Preprint

0

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Introduction: Gliosarcoma is a histopathological variant of glioblastoma, which is characterized by a biphasic growth pattern consisting of glial and sarcoma components. Owing to its scarcity, data regarding the impact of available treatments on the clinical outcomes of gliosarcoma are inadequate. The purpose of this retrospective cohort study was to analyze the prognostic factors of gliosarcoma. Methods By screening the clinical database of neurosurgical cases at a single center, patients with gliosarcoma diagnosed histologically from 2015 to 2021 were identified. Clinical, pathological and molecular data were gathered founded on medical records and follow-up interviews. Prognostic factors were derived using Cox proportional hazards model with backward stepwise regression analysis. Results Forty-five GSM patients were included. Median overall survival was 20.6 months (95%CI 5.8 – 35.3), and median relapse free survival was 15.2 months (95%CI 6.1 – 24.3). In multivariable analysis, total resection (p = 0.029, HR = 0.198, 95%CI 0.046 – 0.849) indicated an improved prognosis. And low expression of Ki-67 (p = 0.067, HR = 2.813, 95%CI 0.930 – 8.506) would be likely to show statistical significance. However, there might be no statistically significant survival benefit from radiotherapy (n = 33, 75%, log-rank p = 0.92), adjuvant temozolomide (n = 33, 73.3%, log-rank p = 0.78) or concurrent temozolomide (n = 36, 80%, log-rank p = 0.79). Conclusion This retrospective study with a limited cohort size has demonstrated the treatment of gross total resection and low expression of Ki-67 are beneficial for patients with GSM, while radiotherapy or temozolomide is not.

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“…The median OS in our study was 25.6 months and longer than those in most other studies, which range from 5.7 months to 24.7 months [ 24 , 25 ]. The results of our study suggested that total resection of GSM was associated with prolonged OS and RFS.…”

Section: Discussioncontrasting

confidence: 62%

“…The results of our study suggested that total resection of GSM was associated with prolonged OS and RFS. Although some retrospective studies have reached the opposite conclusions [ 9 , 11 , 24 ], the resection range is a well-accepted independent prognostic factor for improved OS in GSM [ 4 , 5 , 17 , 26 , 27 ]. Cachia et al reported that patients of primary GSM undergoing GTR tended to have a greater OS (median 24.7 months) than those having subtotal resection (median 10.1 months) [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Gliosarcoma in the Real World: A Retrospective Cohort Study

Yu

¹

,

Zhou

²

,

Xu

³

et al. 2023

Computational and Mathematical Methods in Medicine

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Purpose. Gliosarcoma is a histopathological variant of glioblastoma, which is characterized by a biphasic growth pattern consisting of glial and sarcoma components. Owing to its scarcity, data regarding the impact of available treatments on the clinical outcomes of gliosarcoma are inadequate. The purpose of this retrospective cohort study was to analyze the prognostic factors of gliosarcoma. Methods. By screening the clinical database of neurosurgical cases at a single center, patients with gliosarcoma diagnosed histologically from 2013 to 2021 were identified. Clinical, pathological, and molecular data were gathered founded on medical records and follow-up interviews. Prognostic factors were derived using the Cox proportional hazards model with backward stepwise regression analysis. Results. Forty-five GSM patients were included. Median overall survival was 25.6 months (95% CI 8.0–43.1), and median relapse-free survival was 15.2 months (95% CI 9.7–20.8). In multivariable analysis, total resection ( p = 0.023 , HR = 0.192 , 95% CI 0.046–0.797) indicated an improved prognosis. And low expression of Ki-67 ( p = 0.059 , HR = 2.803 , 95% CI 0.963–8.162) would be likely to show statistical significance. However, there might be no statistically significant survival benefit from radiotherapy with concurrent temozolomide ( n = 33 , 73.3%, log-rank p = 0.99 ) or adjuvant temozolomide ( n = 32 , 71.1%, log-rank p = 0.74 ). Conclusion. This single-center retrospective study with a limited cohort size has demonstrated the treatment of gross total resection and low expression of Ki-67 which are beneficial for patients with GSM, while radiotherapy or temozolomide is not.

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Primary Intracranial Gliosarcoma: Is It Really a Variant of Glioblastoma? An Update of the Clinical, Radiological, and Biomolecular Characteristics

La Torre,

Della Torre,

Lo Turco

et al. 2023

JCM

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Gliosarcomas (GS) are sporadic malignant tumors classified as a Glioblastoma (GBM) variant with IDH-wild type phenotype. It appears as a well-circumscribed lesion with a biphasic, glial, and metaplastic mesenchymal component. The current knowledge about GS comes from the limited literature. Furthermore, recent studies describe peculiar characteristics of GS, such as hypothesizing that it could be a clinical–pathological entity different from GBM. Here, we review radiological, biomolecular, and clinical data to describe the peculiar characteristics of PGS, treatment options, and outcomes in light of the most recent literature. A comprehensive literature review of PubMed and Web of Science databases was conducted for articles written in English focused on gliosarcoma until 2023. We include relevant data from a few case series and only a single meta-analysis. Recent evidence describes peculiar characteristics of PGS, suggesting that it might be a specific clinical–pathological entity different from GBM. This review facilitates our understanding of this rare malignant brain tumor. However, in the future we recommend multi-center studies and large-scale metanalyses to clarify the biomolecular pathways of PGS to develop new specific therapeutic protocols, different from conventional GBM therapy in light of the new therapeutic opportunities.

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Chasing a rarity: a retrospective single-center evaluation of prognostic factors in primary gliosarcoma

Cited by 3 publications

References 35 publications

Prognostic Factors of Gliosarcoma in the Real World: A Retrospective Cohort Study

Prognostic Factors of Gliosarcoma in the Real World: A Retrospective Cohort Study

Prognostic Factors of Gliosarcoma in the Real World: A Retrospective Cohort Study

Primary Intracranial Gliosarcoma: Is It Really a Variant of Glioblastoma? An Update of the Clinical, Radiological, and Biomolecular Characteristics

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