Natural Course and Prognosis of Primary Spinal Glioblastoma: A Nationwide Study.
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
04 04 2023
04 04 2023
Historique:
received:
30
06
2022
accepted:
05
12
2022
medline:
5
4
2023
pubmed:
24
1
2023
entrez:
23
1
2023
Statut:
ppublish
Résumé
Primary spinal glioblastoma (PsGBM) is extremely rare. The dramatic neurologic deterioration and unresectability of PsGBM makes it a particularly disabling malignant neoplasm. Because it is a rare and heterogeneous disease, the assessment of prognostic factors remains limited. PsGBMs were identified from the French Brain Tumor Database and the Club de Neuro-Oncologie of the Société Française de Neurochirurgie retrospectively. Inclusion criteria were age 18 years or older at diagnosis, spinal location, histopathologic diagnosis of newly glioblastoma according to the 2016 World Health Organization classification, and surgical management between 2004 and 2016. Diagnosis was confirmed by a centralized neuropathologic review. The primary outcome was overall survival (OS). Therapeutic interventions and neurologic outcomes were also collected. Thirty-three patients with a histopathologically confirmed PsGBM (median age 50.9 years) were included (27 centers). The median OS was 13.1 months (range 2.5-23.7), and the median progression-free survival was 5.9 months (range 1.6-10.2). In multivariable analyses using Cox model, Eastern Cooperative Oncology Group (ECOG) performance status at 0-1 was the only independent predictor of longer OS (hazard ratio [HR] 0.13, 95% CI 0.02-0.801; Preoperative ECOG performance status, KPS score, and the location are independent predictors of OS of PsGBMs in adults. Further analyses are required to capture the survival benefit of concomitant standard radiochemotherapy with temozolomide.
Sections du résumé
BACKGROUND AND OBJECTIVES
Primary spinal glioblastoma (PsGBM) is extremely rare. The dramatic neurologic deterioration and unresectability of PsGBM makes it a particularly disabling malignant neoplasm. Because it is a rare and heterogeneous disease, the assessment of prognostic factors remains limited.
METHODS
PsGBMs were identified from the French Brain Tumor Database and the Club de Neuro-Oncologie of the Société Française de Neurochirurgie retrospectively. Inclusion criteria were age 18 years or older at diagnosis, spinal location, histopathologic diagnosis of newly glioblastoma according to the 2016 World Health Organization classification, and surgical management between 2004 and 2016. Diagnosis was confirmed by a centralized neuropathologic review. The primary outcome was overall survival (OS). Therapeutic interventions and neurologic outcomes were also collected.
RESULTS
Thirty-three patients with a histopathologically confirmed PsGBM (median age 50.9 years) were included (27 centers). The median OS was 13.1 months (range 2.5-23.7), and the median progression-free survival was 5.9 months (range 1.6-10.2). In multivariable analyses using Cox model, Eastern Cooperative Oncology Group (ECOG) performance status at 0-1 was the only independent predictor of longer OS (hazard ratio [HR] 0.13, 95% CI 0.02-0.801;
DISCUSSION
Preoperative ECOG performance status, KPS score, and the location are independent predictors of OS of PsGBMs in adults. Further analyses are required to capture the survival benefit of concomitant standard radiochemotherapy with temozolomide.
Identifiants
pubmed: 36690453
pii: WNL.0000000000206834
doi: 10.1212/WNL.0000000000206834
pmc: PMC10104612
doi:
Substances chimiques
Temozolomide
YF1K15M17Y
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1497-e1509Informations de copyright
© 2023 American Academy of Neurology.
Références
J Neurooncol. 2000 May;47(3):231-8
pubmed: 11016740
J Neurosurg. 1981 Mar;54(3):323-30
pubmed: 7463133
J Neurosurg Spine. 2010 Feb;12(2):144-53
pubmed: 20121348
J Clin Neurosci. 2015 Dec;22(12):1877-82
pubmed: 26601809
Neurosurgery. 2008 Jul;63(1):55-60; discussion 60-1
pubmed: 18728568
Paraplegia. 1969 Nov;7(3):179-92
pubmed: 5360915
Neurochirurgie. 2012 Feb;58(1):4-13
pubmed: 22385800
J Neurooncol. 2000 May;47(3):219-24
pubmed: 11016738
J Neurol Neurosurg Psychiatry. 1976 Mar;39(3):290-6
pubmed: 932744
Cancer. 2003 Aug 1;98(3):554-61
pubmed: 12879473
Cancer. 1994 Aug 15;74(4):1383-97
pubmed: 8055462
Cancer. 2008 Sep 1;113(5):1019-24
pubmed: 18615600
N Engl J Med. 2005 Mar 10;352(10):987-96
pubmed: 15758009
Neurosurgery. 2021 Mar 15;88(4):E323-E329
pubmed: 33432978
J Neurosurg. 1998 Feb;88(2):215-20
pubmed: 9452226
J Cancer Res Clin Oncol. 2021 Jun;147(6):1843-1856
pubmed: 33399987
Neurosurgery. 2012 Jan;70(1):234-43; discussion 243-4
pubmed: 21593697
Eur J Cancer. 2021 May;149:23-33
pubmed: 33819718
J Neurooncol. 2019 Jan;141(2):337-345
pubmed: 30414100
Spine (Phila Pa 1976). 2012 May 20;37(12):E727-35
pubmed: 22609727
Ideggyogy Sz. 2003 Jan 20;56(1-2):28-32
pubmed: 12690787
J Neurooncol. 1997 Jul;33(3):205-11
pubmed: 9195492
Neurosurgery. 1991 Feb;28(2):302-6
pubmed: 1847741
J Neurosurg. 1992 Sep;77(3):355-9
pubmed: 1506881
Cancer. 1998 Dec 1;83(11):2391-9
pubmed: 9840540
N Engl J Med. 2005 Mar 10;352(10):997-1003
pubmed: 15758010
Neuro Oncol. 2010 Jul;12(7):725-35
pubmed: 20364023
Acta Neuropathol. 2018 Nov;136(5):793-803
pubmed: 30187121
J Neurosurg. 1989 Jan;70(1):50-4
pubmed: 2909688
Int J Radiat Oncol Biol Phys. 2009 Mar 1;73(3):727-33
pubmed: 18687533
Eur Spine J. 2009 Oct;18(10):1397-422
pubmed: 19562388
Am J Public Health. 2013 Jan;103(1):39-40
pubmed: 23153131
N Engl J Med. 2009 Feb 19;360(8):765-73
pubmed: 19228619
J Neurointerv Surg. 2021 Sep;13(9):841-847
pubmed: 33883210
World Neurosurg. 2016 Feb;86:341-8.e1-3
pubmed: 26348566
Acta Neuropathol. 2016 Jun;131(6):803-20
pubmed: 27157931