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Cerebral gliosarcoma: Analysis of 16 patients and review of literature.

Singh G, Das KK, Sharma P, Guruprasad B, Jaiswal S, Mehrotra A, Srivastava AK, Sahu RN, Jaiswal AK, Behari S - Asian J Neurosurg (2015 Jul-Sep)

Bottom Line: Patients with well-demarcated, enhancing mass on imaging intraoperatively had firm tumors with a good plane of cleavage and had a better survival (8 months) compared to those in whom the tumor radiologically and intraoperatively mimicked GBM (2 months).GS is associated with poor survival (median survival 6 months).While the former histologically mimics GBM and has very poor survival (2 months), GS with meningioma like feature tends to have better survival (8 months).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow, Uttar Pradesh, India.

ABSTRACT

Background: Gliosarcoma (GS), a subtype of glioblastoma (GBM), is a rare primary neoplasm of the central nervous system. Certain features like temporal lobe affinity, tendency for extraneural metastasis and poorer outcome compared to GBM indicate that GS may indeed be a separate clinicopathologic entity. This led us to revisit this entity in our settings.

Materials and methods: Between 2009 and 2014, 16 cases of histologically proven GSs (14 primary, two secondary) were treated. Patient data were retrieved retrospectively. Statistical analysis was performed with? Statistical Package for Social Sciences, version 17.0. (Chicago, Illinois, USA). Survival was analyzed by Kaplan-Meier method.

Results: GS predominantly affected males in their fifth decade of life. Raised intracranial pressure was the most common mode of clinical presentation. Temporal lobe was the most commonly affected part of the brain and majority of primary and all of secondary GBM were located peripherally. In 7 (43.8%) patients, tumor was radiologically well-demarcated and enhanced strongly and homogenously on contrast as compared to 9 (56.2%) patients where the tumor was ill-defined and showed heterogenous patchy or ring enhancement. Extent of excision was total in seven patients (43.8%), near total in 4 (25%) and subtotal in five patients (31.2%). Median survival was 6 months. Patients with well-demarcated, enhancing mass on imaging intraoperatively had firm tumors with a good plane of cleavage and had a better survival (8 months) compared to those in whom the tumor radiologically and intraoperatively mimicked GBM (2 months).

Conclusion: GS is associated with poor survival (median survival 6 months). Radiological and intraoperative findings help categorize these tumors into GBM like GS and meningioma like GS. While the former histologically mimics GBM and has very poor survival (2 months), GS with meningioma like feature tends to have better survival (8 months).

No MeSH data available.


Related in: MedlinePlus

The survival curve. The median overall survival was 6 months
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Figure 7: The survival curve. The median overall survival was 6 months

Mentions: Outcome data were available for 11 out of 15 patients who were discharged after surgery. Eight patients had died while remaining three patients were surviving at mean follow-up of 9.6 months. Kaplan–Meier analysis revealed a median survival of 6 months [Figure 7]. Three patients survived 18 months or more with the maximum survival of 36 months. Although not significant, there was marked difference in survival between Group A and B (8 months vs. 2 months, P = 0.4) Table 2 shows extent of excision, operative findings, surgical complications, adjuvant therapy, and outcome of GS patients in our series.


Cerebral gliosarcoma: Analysis of 16 patients and review of literature.

Singh G, Das KK, Sharma P, Guruprasad B, Jaiswal S, Mehrotra A, Srivastava AK, Sahu RN, Jaiswal AK, Behari S - Asian J Neurosurg (2015 Jul-Sep)

The survival curve. The median overall survival was 6 months
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553731&req=5

Figure 7: The survival curve. The median overall survival was 6 months
Mentions: Outcome data were available for 11 out of 15 patients who were discharged after surgery. Eight patients had died while remaining three patients were surviving at mean follow-up of 9.6 months. Kaplan–Meier analysis revealed a median survival of 6 months [Figure 7]. Three patients survived 18 months or more with the maximum survival of 36 months. Although not significant, there was marked difference in survival between Group A and B (8 months vs. 2 months, P = 0.4) Table 2 shows extent of excision, operative findings, surgical complications, adjuvant therapy, and outcome of GS patients in our series.

Bottom Line: Patients with well-demarcated, enhancing mass on imaging intraoperatively had firm tumors with a good plane of cleavage and had a better survival (8 months) compared to those in whom the tumor radiologically and intraoperatively mimicked GBM (2 months).GS is associated with poor survival (median survival 6 months).While the former histologically mimics GBM and has very poor survival (2 months), GS with meningioma like feature tends to have better survival (8 months).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow, Uttar Pradesh, India.

ABSTRACT

Background: Gliosarcoma (GS), a subtype of glioblastoma (GBM), is a rare primary neoplasm of the central nervous system. Certain features like temporal lobe affinity, tendency for extraneural metastasis and poorer outcome compared to GBM indicate that GS may indeed be a separate clinicopathologic entity. This led us to revisit this entity in our settings.

Materials and methods: Between 2009 and 2014, 16 cases of histologically proven GSs (14 primary, two secondary) were treated. Patient data were retrieved retrospectively. Statistical analysis was performed with? Statistical Package for Social Sciences, version 17.0. (Chicago, Illinois, USA). Survival was analyzed by Kaplan-Meier method.

Results: GS predominantly affected males in their fifth decade of life. Raised intracranial pressure was the most common mode of clinical presentation. Temporal lobe was the most commonly affected part of the brain and majority of primary and all of secondary GBM were located peripherally. In 7 (43.8%) patients, tumor was radiologically well-demarcated and enhanced strongly and homogenously on contrast as compared to 9 (56.2%) patients where the tumor was ill-defined and showed heterogenous patchy or ring enhancement. Extent of excision was total in seven patients (43.8%), near total in 4 (25%) and subtotal in five patients (31.2%). Median survival was 6 months. Patients with well-demarcated, enhancing mass on imaging intraoperatively had firm tumors with a good plane of cleavage and had a better survival (8 months) compared to those in whom the tumor radiologically and intraoperatively mimicked GBM (2 months).

Conclusion: GS is associated with poor survival (median survival 6 months). Radiological and intraoperative findings help categorize these tumors into GBM like GS and meningioma like GS. While the former histologically mimics GBM and has very poor survival (2 months), GS with meningioma like feature tends to have better survival (8 months).

No MeSH data available.


Related in: MedlinePlus