Clinical and survival characteristics of primary and secondary gliosarcoma patients

Gliosarcoma (GS) is classified by the World Health Organization as a subtype of glioblastoma with sarcomatous features. GS have a propensity to metastasize, as opposed to other gliomas, with lower 5-year survival rates than GBM patients. In this study, we identified differences in survival between p...

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Veröffentlicht in:Clinical neurology and neurosurgery 2022-03, Vol.214, p.107146-107146, Article 107146
Hauptverfasser: Amer, Ahmad, Khose, Swapnil, Alhasan, Hamza, Pokhylevych, Halyna, Fuller, Greg, Chasen, Noah, de Groot, John, Johnson, Jason M.
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container_end_page 107146
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container_start_page 107146
container_title Clinical neurology and neurosurgery
container_volume 214
creator Amer, Ahmad
Khose, Swapnil
Alhasan, Hamza
Pokhylevych, Halyna
Fuller, Greg
Chasen, Noah
de Groot, John
Johnson, Jason M.
description Gliosarcoma (GS) is classified by the World Health Organization as a subtype of glioblastoma with sarcomatous features. GS have a propensity to metastasize, as opposed to other gliomas, with lower 5-year survival rates than GBM patients. In this study, we identified differences in survival between patients with primary and secondary GS. We retrospectively identified patients who presented at the MD Anderson Cancer Center with a pathology-confirmed diagnosis of GS. We defined overall survival (OS) from the date of pathological diagnosis of primary GS (from sarcomatous change for secondary GS). We defined progression-free survival (PFS) from the date of GS chemoradiation completion to radiographic disease progression. We used Kaplan-Meier survival estimates and the log-rank test to compare OS and PFS between primary and secondary GS. We used univariable Cox proportional hazard regression to assess differences in OS & PFS by various characteristics. We identified 94 GS patients; 70 had primary disease and 24 secondary. Molecular analysis of GS tumor samples revealed that 47.1% were GFAP positive, 38.5% S-100 positive, and 83.7% reticulin-positive. Among the tested samples, 3.8% had IDH and 73.1% had TP53 mutations. The median OS for all patients was 16.8 months. Median OS from the pathological diagnosis of GS was 17.3 months for primary and 10.2 months for secondary GS. Median OS for secondary GS was 28.9 months from initial diagnosis of the primary neoplasm. Our study is the largest single institution evaluation of GS and provides insight into patterns of survival for GS. •Largest single institution study of gliosarcoma, providing insight into demographic, pathologic, and survival characteristics.•Secondary gliosarcoma patients had a lower survival rate than their primary counterparts.•Lower survival indicates a need for adjunctive therapy in addition to the established treatment regimes for brain tumors.•Radiotherapy is an effective means of treatment for gliosarcoma patients, improving overall survival by 10 months.•Gliosarcoma is variable in clinical and molecular presentation so it is difficult to rule it out through molecular testing.
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GS have a propensity to metastasize, as opposed to other gliomas, with lower 5-year survival rates than GBM patients. In this study, we identified differences in survival between patients with primary and secondary GS. We retrospectively identified patients who presented at the MD Anderson Cancer Center with a pathology-confirmed diagnosis of GS. We defined overall survival (OS) from the date of pathological diagnosis of primary GS (from sarcomatous change for secondary GS). We defined progression-free survival (PFS) from the date of GS chemoradiation completion to radiographic disease progression. We used Kaplan-Meier survival estimates and the log-rank test to compare OS and PFS between primary and secondary GS. We used univariable Cox proportional hazard regression to assess differences in OS &amp; PFS by various characteristics. We identified 94 GS patients; 70 had primary disease and 24 secondary. 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Our study is the largest single institution evaluation of GS and provides insight into patterns of survival for GS. •Largest single institution study of gliosarcoma, providing insight into demographic, pathologic, and survival characteristics.•Secondary gliosarcoma patients had a lower survival rate than their primary counterparts.•Lower survival indicates a need for adjunctive therapy in addition to the established treatment regimes for brain tumors.•Radiotherapy is an effective means of treatment for gliosarcoma patients, improving overall survival by 10 months.•Gliosarcoma is variable in clinical and molecular presentation so it is difficult to rule it out through molecular testing.</description><identifier>ISSN: 0303-8467</identifier><identifier>EISSN: 1872-6968</identifier><identifier>DOI: 10.1016/j.clineuro.2022.107146</identifier><identifier>PMID: 35101778</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Brain cancer ; Brain Neoplasms ; Chemoradiotherapy ; Diagnosis ; Glial fibrillary acidic protein ; Glioblastoma ; Glioblastoma - genetics ; Glioblastoma - therapy ; Gliosarcoma ; Gliosarcoma - therapy ; Humans ; Metastasis ; Mutation ; Neurology ; Patients ; Primary gliosarcoma ; Radiation therapy ; Retrospective Studies ; Secondary gliosarcoma ; Survival ; Survival analysis ; TP53 mutation ; Treatment Outcome ; Tumors</subject><ispartof>Clinical neurology and neurosurgery, 2022-03, Vol.214, p.107146-107146, Article 107146</ispartof><rights>2022 Elsevier B.V.</rights><rights>Copyright © 2022 Elsevier B.V. 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GS have a propensity to metastasize, as opposed to other gliomas, with lower 5-year survival rates than GBM patients. In this study, we identified differences in survival between patients with primary and secondary GS. We retrospectively identified patients who presented at the MD Anderson Cancer Center with a pathology-confirmed diagnosis of GS. We defined overall survival (OS) from the date of pathological diagnosis of primary GS (from sarcomatous change for secondary GS). We defined progression-free survival (PFS) from the date of GS chemoradiation completion to radiographic disease progression. We used Kaplan-Meier survival estimates and the log-rank test to compare OS and PFS between primary and secondary GS. We used univariable Cox proportional hazard regression to assess differences in OS &amp; PFS by various characteristics. We identified 94 GS patients; 70 had primary disease and 24 secondary. Molecular analysis of GS tumor samples revealed that 47.1% were GFAP positive, 38.5% S-100 positive, and 83.7% reticulin-positive. Among the tested samples, 3.8% had IDH and 73.1% had TP53 mutations. The median OS for all patients was 16.8 months. Median OS from the pathological diagnosis of GS was 17.3 months for primary and 10.2 months for secondary GS. Median OS for secondary GS was 28.9 months from initial diagnosis of the primary neoplasm. Our study is the largest single institution evaluation of GS and provides insight into patterns of survival for GS. •Largest single institution study of gliosarcoma, providing insight into demographic, pathologic, and survival characteristics.•Secondary gliosarcoma patients had a lower survival rate than their primary counterparts.•Lower survival indicates a need for adjunctive therapy in addition to the established treatment regimes for brain tumors.•Radiotherapy is an effective means of treatment for gliosarcoma patients, improving overall survival by 10 months.•Gliosarcoma is variable in clinical and molecular presentation so it is difficult to rule it out through molecular testing.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>35101778</pmid><doi>10.1016/j.clineuro.2022.107146</doi><tpages>1</tpages></addata></record>
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subjects Brain cancer
Brain Neoplasms
Chemoradiotherapy
Diagnosis
Glial fibrillary acidic protein
Glioblastoma
Glioblastoma - genetics
Glioblastoma - therapy
Gliosarcoma
Gliosarcoma - therapy
Humans
Metastasis
Mutation
Neurology
Patients
Primary gliosarcoma
Radiation therapy
Retrospective Studies
Secondary gliosarcoma
Survival
Survival analysis
TP53 mutation
Treatment Outcome
Tumors
title Clinical and survival characteristics of primary and secondary gliosarcoma patients
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