Impact of surgery and radiation therapy on spinal high-grade gliomas: a population-based study

Liu, Jiang; Zheng, Minghui; Yang, Wuyang; Lo, Sheng Fu L.; Huang, Judy

doi:10.1007/s11060-018-2904-7

Cited by 22 publications

(23 citation statements)

References 22 publications

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“…In the analysis of Adams et al, only the histological subtype, age at diagnosis (child and adult), sex, and the extent of resection were associated with survival [1]. On the other hand, Liu et al report that tumor size and the extend of surgery had no significant impact on survival of adult patients, whereas postoperative radiotherapy is associated with prolonged survival [16] (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Primary bulbo-medullary glioblastoma in a child: case report

et al. 2019

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Glioblastoma (GBM) of the spinal cord represents a rare entity in children and account for less than 1% of all central nervous system (CNS) cancers. Their biology, localization, and controversial treatment options have been discussed in a few pediatric cases. Here, we report a case of primary spinal cord glioblastoma in a 5-year-old girl having the particularity to be extended to the brainstem. This tumor has been revealed by torticollis and bilateral brachial paresis. The patient underwent subtotal resection; unfortunately, she died in reanimation 1 week later by severe pneumopathy. To the best of our knowledge, this is the first case in the literature reporting this particular localization in a child. Beyond their dismal prognosis, we discuss the rarity of the disease and describe the peculiar characteristics, management, and prognosis of this rare tumor in pediatric oncology. This case appears to be unusual for both the histological type and the extension to brain stern.

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Section: Discussionmentioning

confidence: 99%

Primary bulbo-medullary glioblastoma in a child: case report

et al. 2019

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“…Before the 2016 WHO classification of tumors of the central nervous system, it had been accepted that gross total resection was associated with better survival of histological grade II spinal cord astrocytoma [7,9,17]. However, the prognostic value of surgery resection extent in high grade (histological III and IV) spinal cord astrocytoma is still confused, and it seems that surgery resection only has prognostic value in anaplastic spinal cord astrocytoma (histological grade III), but not spinal cord glioblastoma (histological grade IV) [3,15,18]. Based on the integrated diagnosis of 2016 WHO classification, H3 K27M-mutant histological grade II/III spinal cord astrocytoma is also classified as WHO grade IV [10,34], and WHO grade II/III tumors with similar molecular features are commonly studied together as lower-grade gliomas.…”

Section: Discussionmentioning

confidence: 99%

“…Although our current knowledge is incomplete for prognosis factors of spinal cord gliomas, some clinicopathological features had been reported to be associated with the prognosis of the spinal cord [4][5][6][7]12]. Histologic grade, WHO grade, preoperative neurological status, surgical extent, and Ki-67 index had been reported as prognostic factors in previous studies [3,5,14,15,17,18]. However, these findings still should be verified in a relatively large cohort.…”

Section: Introductionmentioning

confidence: 91%

“…Accurate prediction of spinal cord glioma prognosis is critical for postoperative management and treatment. Currently, the common treatment for spinal cord gliomas is maximal safe surgical resection, and adjuvant chemotherapy and radiation therapy (RT) are also used for recurrent or progressive residual tumors [13][14][15]. However, an aggressive and combined modality treatment approach may be adopted for a very poor prognosis patient, while avoidance of long-term nerve injury should be considered for patients with a relatively favorable prognosis [7,16].…”

Section: Introductionmentioning

confidence: 99%

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A comprehensive model including preoperative peripheral blood inflammatory markers for prediction of the prognosis of diffuse spinal cord astrocytoma following surgery

et al. 2021

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Purpose Due to the rarity of diffuse spinal cord astrocytoma, an effective model is still lacking to stratify their prognosis. Here, we aimed to establish a prognostic model through comprehensively evaluating clinicopathological features and preoperative peripheral blood inflammatory markers in 89 cases. Methods We performed univariate and multivariate Cox regression to identify prognosis factors. The Kaplan–Meier curves and ROC curves were employed to compare the prognostic value of selected factors. Results In addition to clinicopathological factors, we revealed the preoperative peripheral blood leukocyte count, neutrophils-to-lymphocytes ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were also significantly correlated with overall survival of spinal cord astrocytoma in univariate Cox regression, and NLR was still significant in multivariate Cox analysis. Further, we demonstrated that NLR ≤ 3.65 and preoperative McCormick score (MMS) ≤ 3 were independently correlated with better survival of WHO grade IV tumors. Meanwhile, Ki-67 < 10% and resection extent ≥ 90% were independent prognostic factors in WHO grade II/III tumors. Finally, we developed a prognostic model that had better predictive efficiencies than WHO grade and histological grade for 1-year (AUC = 76.6), 2- year (AUC = 80.9), and 3-year (AUC = 80.3) survival. This model could classify tumors into 4 classifications with increasingly poor prognosis: 1, WHO grade II/III, with Ki-67 < 10% and resection extent ≥ 90%; 2, WHO grade II/III, Ki-67 ≥ 10% or resection < 90%; 3, WHO grade IV, NLR ≤ 3.65 and MMS ≤ 3; 4, WHO grade IV, with NRL > 3.65 or MMS = 4. Conclusion We successfully constructed a comprehensive prognostic model including preoperative peripheral blood inflammatory markers, which can stratify diffuse spinal cord astrocytoma into 4 subgroups.

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“…The role of radiotherapy and chemotherapy in GBM is still much debated. In their study of 158 high-grade spinal cord gliomas, Jiang Lui et al (39) found that the use of postoperative RT offered a survival benefit, especially in pediatrics (22). Minehan et al (40) found that postoperative RT substantially enhanced overall survival in high grade gliomas.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Metastases Originating From Pediatric Primary Spinal Cord Glioblastoma Multiforme: A Case Report and Literature Review

Song

Gao

et al. 2020

Front. Oncol.

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Primary spinal cord glioblastoma multiforme (scGBM) is an uncommon entity in pediatrics, and intracranial metastasis originating in spinal cord gliomas is very rare. A 7-year-old female presented with weakness in the limbs, paralysis of the lower limbs and incontinence. The initial MRI of the spinal cord revealed expansion and abnormal signals from T2 to T5. She was initially diagnosed with Neuromyelitis optica spectrum disorders and treated with high-dose glucocorticoid and gamma globulin. Four months later, her symptoms worsened and follow-up imaging showed multiple intracranial mass lesions. We performed a subtotal resection of the right thalamic basal ganglia tumor and gross total resection of the right frontal lobe tumor under microscopic examination. Histopathology revealed scGBM with intracranial metastasis and the molecular pathology diagnosis suggested H3K27M mutant diffuse midline glioma WHO grade IV, which had previously been misdiagnosed as a Neuromyelitis optica spectrum disorders. We review the literature of intracranial metastases originating from pediatric primary spinal cord glioblastoma multiforme and summarize possible methods of differentiation, including changes in muscle strength or tone, intramedullary heterogeneously enhancing solitary mass lesions and cord expansion in MRI. Finally, we emphasize that in unexpected radiological changes or disadvantageous response to the treatment, a biopsy to achieve a pathological diagnosis is necessary to discard other diseases, especially neoplasms.

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Impact of surgery and radiation therapy on spinal high-grade gliomas: a population-based study

Cited by 22 publications

References 22 publications

Primary bulbo-medullary glioblastoma in a child: case report

Primary bulbo-medullary glioblastoma in a child: case report

A comprehensive model including preoperative peripheral blood inflammatory markers for prediction of the prognosis of diffuse spinal cord astrocytoma following surgery

Intracranial Metastases Originating From Pediatric Primary Spinal Cord Glioblastoma Multiforme: A Case Report and Literature Review

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