Primary Spinal Cord Glioblastoma Multiforme: A Retrospective Study of Patients at a Single Institution

Abstract [Background and objective] Primary spinal cord (PSC) glioblastoma multiforme GBM is extremely rare, which accounts for only 1.5% of all SC tumors. Therefore, its treatment is still ill defined. To elucidate prognostic factors, we performed a single-institutional retrospective review on the largest series to date of the patients with PSCGBM who underwent surgical resection in West China Hospital during the period between 2008 and 2014. A total of 14 PSCGBM patients were collected. [Method] Demographic, operative, and post-operative factors were recorded. OS and PFS were calculated and compared with Kaplan-Meier (K-M) method. [Result] There were 8 males (57%) and 6 females (43%) involved in the study. Their median age was 28 years old (age range: 14-56). Median KPS was 60 (range: 20-90). 4 patients (28.6%) received gross total resection (GTR), 5 (35.7%) partial resection, and the rest 5 (35.7%) biopsy only. 9 patients (64.3%) accepted post-operative radiotherapy and chemotherapy, 3 (21.4%) chemotherapy only, and 2 (14.3%) neither. Median follow-up period was 15 months (range: 5-26 months). One-year and two-year survival rate was 78.5% (11/14) and 7.1% (1/14), respectively. Median OS was 15 months, and median PFS 8 months. Univariate log-rank analysis showed that OS and PFS were significantly associated with patients’ age (p = 0.007, p = 0.04, respectively) and post-operative radiotherapy (p = 0.001, p = 0.002, respectively). However, pre-operative KPS score only affected OS. That is to say, it did not affect PFS (p = 0.033, p = 0.106, respectively). [Conclusion] According to our study result, the combination of post-operative radiotherapy and temozolomide chemotherapy can improve prognosis, and may serve as a feasible post-operative adjuvant treatment of PSCGBM.