Prognostic Factors and Survival of Gliomatosis Cerebri: A Systematic Review and Meta-Analysis

Georgakis, Marios K.; Tsivgoulis, Georgios; Spinos, Dimitrios; Liaskas, Athanasios; Herrlinger, Ulrich; Petridou, Eleni

doi:10.1016/j.wneu.2018.08.173

Cited by 11 publications

(18 citation statements)

References 214 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…IDH1 and IDH2 mutations are known to be very rare among children with high-grade gliomas, as opposed to older patients, 14,24 but similarly to other gliomas, 25 paradoxically pediatric gliomatosis cerebri tumors are associated with prolonged survival. 12 Besides IDH1 mutations, other clinical and neuroimaging markers that could be of help in the clinical prognostication of children with gliomatosis cerebri were identified as independent prognostic factors for overall survival. Those included age >4 years at diagnosis, higher number of central nervous system infiltrated regions, and the symptoms of cognitive decline and coordination abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…Those included age >4 years at diagnosis, higher number of central nervous system infiltrated regions, and the symptoms of cognitive decline and coordination abnormalities. These symptoms, might also indicate more extensive central nervous system infiltrations, and have also been associated with worse outcome in adult gliomatosis cerebri, 12 but also other pediatric gliomas. 26 However, an age at diagnosis of 0-4 years is considered an unfavorable prognostic factors for other pediatric brain tumors.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of potential prognostic factors on overall survival was initially examined in multivariable Cox proportional hazard models. A core set of variables, determined by literature reports for prognostic factors, 12 findings of the univariable analysis, data availability (missing values <30%) and collinearity of the candidate variables, was included in the multivariable models. These variables were age, sex, histology, grade, gliomatosis cerebri type (I or II), and number of central nervous system regions affected.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, we gathered available evidence for gliomatosis cerebri by performing a systematic review and an individual-patient data meta-analysis on 866 gliomatosis cerebri patients that have been described in biomedical literature. 11,12 Using this approach, it was possible for the first time to study to such an extent the diagnostic features of the disease, its prognostic factors, and the impact of treatment on outcome. Given the well-established differences in the molecular basis and in the epidemiology of brain tumors in children, as compared to the brain tumors later in life, 13,14 in this study, we aimed to elaborate data from the abovementioned data set 11,12 to describe the diagnostic and prognostic features of gliomatosis cerebri among pediatric patients and explore whether they differ from adult gliomatosis cerebri tumors.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Gliomatosis Cerebri Among Children and Adolescents: An Individual-Patient Data Meta-analysis of 182 Patients

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background: Gliomatosis cerebri is a rare but fatal widespread infiltrating central nervous system tumor. We aimed to describe diagnostic and prognostic features of gliomatosis cerebri among children and adolescents. Methods: We conducted a systematic literature review for published case reports and case series on patients with histologically confirmed gliomatosis cerebri and extracted data on an individual patient level for those aged 0-18 years. Multivariable Cox proportional hazard models were fit for overall survival. Results: Following screening of 274 published studies, 182 gliomatosis cerebri patients (63% males) aged 0-18 years with individual-level data available were identified. The most common presenting symptoms were seizures (52%), focal motor deficits (36%), and headache (30%). Imaging showed bilateral hemisphere involvement in 60%, infratentorial infiltration in 39%, and a focal contrast-enhanced mass (type II gliomatosis cerebri) in 27% of cases. Anaplastic astrocytoma was the most common histologic subtype of pediatric gliomatosis cerebri, whereas MGMT promoter methylation, IDH1 mutations, and codeletion of 1p/19q were less common molecular aberrations, as compared to adult gliomatosis cerebri. In the multivariable analyses, age at diagnosis >4 years, extended central nervous system infiltration, coordination abnormalities, and cognitive decline were predictors of worse outcome. Conversely, IDH1 mutations were associated with prolonged overall survival. Chemotherapy and extended surgical resection were associated with improved outcome, whereas radiotherapy was not associated with overall survival and was inferior to chemotherapy alone. Conclusion: Gliomatosis cerebri among children and adolescents presents distinct histopathologic and molecular features compared to adults. However, similar associations of chemotherapy, and, when feasible, extended surgical resection, with favorable outcomes were noted among the 2 age groups.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Gliomatosis Cerebri Among Children and Adolescents: An Individual-Patient Data Meta-analysis of 182 Patients

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Gliomatosis histologically fits within grades II-IV, and the prognosis is worse than that of a localized glioma with the same histologic grade (5). The median progression-free and overall survival for these types of tumors are 10 and 13 and months, respectively, with a five-year survival of 18% (5). Due to the widespread disease within the brain, complete surgical removal of these tumors is extremely difficult or impossible.…”

Section: Introductionmentioning

confidence: 99%

Multimodal neuroimaging of gliomatosis cerebri: a case series of four patients

Bonomi

John

Patel

et al. 2020

Acta Radiologica Open

View full text Add to dashboard Cite

In the latest World Health Organization classification of brain tumors, gliomatosis cerebri has been redefined to varying subsets of diffuse gliomas; however, the term is still used to describe gliomas with infiltrative growth into three or more cerebral lobes. These tumors are frequently misdiagnosed and difficult to treat due to their atypical presentation using structural imaging modalities including computed tomography and T1/T2-weighted magnetic resonance imaging (MRI). In this retrospective case series, we compared clinical MRI to amino acid positron emission tomography (PET) to assess the potential value of PET in the assessment of the extent of tumor involvement and in monitoring disease progression. We report the clinical course and serial multimodal imaging findings of four patients. Each patient presented at varying points in disease progression with widespread glioma brain involvement and was evaluated at least once by amino acid PET using alpha-[11C]methyl-L-tryptophan ([11C]-AMT). Increased uptake of [11C]-AMT was detected in a subset of non-enhancing brain lesions and detected tumor invasion before MRI signs of tumor in some regions. Increased uptake of [11C]-AMT was also detected in tumorous regions not detected by perfusion MRI or MR spectroscopy. Metabolic response to treatment was also observed in two patients. Overall, these data are consistent with and expand upon previous reports using other amino acid PET tracers in gliomatosis and show the potential added value of this imaging modality to clinical MRI in the detection and monitoring of these diffusely infiltrative tumors.

show abstract

High expression of ALDH1A3 might independently influence poor progression‐free and overall survival in patients with glioma via maintaining glucose uptake and lactate production

Xia

Lin

et al. 2019

Cell Biology International

View full text Add to dashboard Cite

Recent studies have found that the acetaldehyde dehydrogenase 1A3 (ALDH1A3) gene is a marker of glioma stem cells. A total of 115 brain glioma specimens were collected and classified into grade I–IV, while non‐tumor brain tissue specimens, taken from 12 patients of vascular malformation surgery, were used as control. ALDH1A3 gene promoter methylation in glioma tissues was detected by pyrosequencing, while immunohistochemistry and western blot were used to detect ALDH1A3 protein expressions in different grades of glioma tissues and normal brain tissues. The expression of ALDH1A3 in the glioma cell line U87 was detected by quantitative real‐time polymerase chain reaction and RNA‐Seq technology was applied to investigate differentially expressed genes before and after silencing the ALDH1A3 gene. Among the 115 glioma tissue specimens, 50 (43.48%) showed low and 65 (56.52%) high expression of ALDH1A3, but no expression was detected in the control. Univariate and multivariate COX regression analyses showed that the patient's tumor pathological grade, the methylation status of ALDH1A3 promoter, and the expression of ALDH1A3 protein were risk factors for progression‐free survival (PFS) and overall survival (OS) (all P < 0.05) and the OS of mice with silenced ALDH1A3 in a glioma nude mouse model was prolonged. U87 experiments revealed that ALDH1A3 expression had significant effects on apoptosis, proliferation, cell cycle, mitochondrial membrane potential, glucose consumption, lactate production, invasion ability, and expression of the pyruvate kinase M2 (PKM2) and hexokinase 2 (HK2) in glioma cells. ALDH1A3 protein expression is a marker for poor PFS and OS in glioma patients.

show abstract

Prognostic Factors and Survival of Gliomatosis Cerebri: A Systematic Review and Meta-Analysis

Cited by 11 publications

References 214 publications

Gliomatosis Cerebri Among Children and Adolescents: An Individual-Patient Data Meta-analysis of 182 Patients

Gliomatosis Cerebri Among Children and Adolescents: An Individual-Patient Data Meta-analysis of 182 Patients

Multimodal neuroimaging of gliomatosis cerebri: a case series of four patients

High expression of ALDH1A3 might independently influence poor progression‐free and overall survival in patients with glioma via maintaining glucose uptake and lactate production

Contact Info

Product

Resources

About