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Erschienen in: Neurological Sciences 5/2021

21.09.2020 | Original Article

Adult brainstem glioma: a multicentre retrospective analysis of 47 Italian patients

verfasst von: Andrea Rigamonti, Giorgia Simonetti, Antonio Silvani, Roberta Rudà, Federica Franchino, Veronica Villani, Andrea Pace, Rossella Merli, Maura Servida, Alberto Picca, Giulia Berzero, Alfonso Cerase, Ivano Chiarotti, Giannantonio Spena, Andrea Salmaggi, On behalf of the neurooncology group of SNO (Society of Hospital Neurosciences, Italy)

Erschienen in: Neurological Sciences | Ausgabe 5/2021

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Abstract

Background and purpose

Adult brainstem gliomas are rare primary brain tumours with heterogeneous clinical course. The low frequency of these tumours makes it difficult to achieve high-quality evidence regarding prognostic factors, adequate therapeutic approach and outcome in such patients.

Methods

In this retrospective study, we analysed clinical, radiological, molecular, prognostic and therapeutic factors in a series of 47 histologically proven adult brainstem gliomas recruited over a 20-year period (1998–2018).

Results

Twenty-two patients were male, 25 female with median age of 39 years. The tumour involved one brainstem segment in 20 cases and 2 or more segments in 27. Contrast enhancement was reported in 28 cases. Surgical procedures included biopsy in 26 cases and partial/total resection in the remaining 21. Histological diagnosis was of low-grade glioma in 23 patients, high-grade glioma in 22 and non-diagnostic in 2 cases. Data regarding molecular biology were available for 22 patients. Median overall survival was 35 months, in particular 16 months in high-grade glioma and 84 months in low-grade glioma. At univariate analysis, tumour grade was the only factor with a statistically significant impact on survival time (p = 0,003), whereas younger age, better performance status and total/subtotal resection showed a trend to more prolonged survival. This study also confirms safety of biopsy/surgery in adult brainstem glioma patients and shows a clear trend to a more frequent assessment of molecular biology data.

Conclusions

Further prospective multicentre efforts, and hopefully clinical trials, are necessary to improve outcome in this neglected glioma patient population.
Literatur
1.
Zurück zum Zitat Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS (2015) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2008-2012. Neuro-Oncology 17(suppl 4):iv1–iv62CrossRef Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS (2015) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2008-2012. Neuro-Oncology 17(suppl 4):iv1–iv62CrossRef
2.
Zurück zum Zitat Guillamo JS, Monjour A, Taillandier L, Devaux B, Varlet P, Haie-Meder C, Defer GL, Maison P, Mazeron JJ, Cornu P, Delattre JY, Association des Neuro-Oncologues d'Expression Française (ANOCEF) (2001) Brainstem gliomas in adults: prognostic factors and classification. Brain 124:2528–2539CrossRef Guillamo JS, Monjour A, Taillandier L, Devaux B, Varlet P, Haie-Meder C, Defer GL, Maison P, Mazeron JJ, Cornu P, Delattre JY, Association des Neuro-Oncologues d'Expression Française (ANOCEF) (2001) Brainstem gliomas in adults: prognostic factors and classification. Brain 124:2528–2539CrossRef
3.
Zurück zum Zitat Schreck KC, Ranjan S, Skorupan N, Bettegowda C, Eberhart CG, Ames HM, Holdhoff M (2019) Incidence and clinicopathologic features of H3 K27M mutations in adults with radiographically-determined midline gliomas. Neurooncol 143(1):87–93CrossRef Schreck KC, Ranjan S, Skorupan N, Bettegowda C, Eberhart CG, Ames HM, Holdhoff M (2019) Incidence and clinicopathologic features of H3 K27M mutations in adults with radiographically-determined midline gliomas. Neurooncol 143(1):87–93CrossRef
4.
Zurück zum Zitat Meyronet D, Esteban-Mader M, Bonnet C, Joly MO, Uro-Coste E, Amiel-Benouaich A, Forest F, Rousselot-Denis C, Burel-Vandenbos F, Bourg V, Guyotat J, Fenouil T, Jouvet A, Honnorat J, Ducray F (2017) Characteristics of H3 K27M-mutant gliomas in adults. Neuro-Oncology 19(8):1127–1134CrossRef Meyronet D, Esteban-Mader M, Bonnet C, Joly MO, Uro-Coste E, Amiel-Benouaich A, Forest F, Rousselot-Denis C, Burel-Vandenbos F, Bourg V, Guyotat J, Fenouil T, Jouvet A, Honnorat J, Ducray F (2017) Characteristics of H3 K27M-mutant gliomas in adults. Neuro-Oncology 19(8):1127–1134CrossRef
5.
Zurück zum Zitat Doyle J, Khalafallah AM, Yang W, Sun Y, Bettegowda C, Mukherjee D (2019) Association between extent of resection on survival in adult brainstem high-grade glioma patients. J Neuro-Oncol 145(3):479–486CrossRef Doyle J, Khalafallah AM, Yang W, Sun Y, Bettegowda C, Mukherjee D (2019) Association between extent of resection on survival in adult brainstem high-grade glioma patients. J Neuro-Oncol 145(3):479–486CrossRef
6.
Zurück zum Zitat Salmaggi A, Fariselli L, Milanesi I, Lamperti E, Silvani A, Bizzi A, Maccagnano E, Trevisan E, Laguzzi E, Rudà R, Boiardi A, Soffietti R, Associazione Italiana di Neuro-oncologia (2008) Natural history and management of brainstem gliomas in adults. A retrospective italian study. J Neurol 255:171–177CrossRef Salmaggi A, Fariselli L, Milanesi I, Lamperti E, Silvani A, Bizzi A, Maccagnano E, Trevisan E, Laguzzi E, Rudà R, Boiardi A, Soffietti R, Associazione Italiana di Neuro-oncologia (2008) Natural history and management of brainstem gliomas in adults. A retrospective italian study. J Neurol 255:171–177CrossRef
7.
Zurück zum Zitat Veldhuijzen van Zanten SEM, Baugh J, Chaney B, De Jongh D, Sanchez Aliaga E, Barkhof F, Noltes J, De Wolf R, Van Dijk J, Cannarozzo A, Damen-Korbijn CM, Lieverst JA, Colditz N, Hoffmann M, Warmuth-Metz M, Bison B, Jones DTW, Sturm D, Gielen GH, Jones C, Hulleman E, Calmon R, Castel D, Varlet P, Giraud G, Slavc I, Van Gool S, Jacobs S, Jadrijevic-Cvrlje F, Sumerauer D, Nysom K, Pentikainen V, Kivivuori SM, Leblond P, Entz-Werle N, von Bueren AO, Kattamis A, Hargrave DR, Hauser P, Garami M, Thorarinsdottir HK, Pears J, Gandola L, Rutkauskiene G, Janssens GO, Torsvik IK, Perek-Polnik M, Gil-da-Costa MJ, Zheludkova O, Shats L, Deak L, Kitanovski L, Cruz O, Morales La Madrid A, Holm S, Gerber N, Kebudi R, Grundy R, Lopez-Aguilar E, Zapata-Tarres M, Emmerik J, Hayden T, Bailey S, Biassoni V, Massimino M, Grill J, Vandertop WP, Kaspers GJL, Fouladi M, Kramm CM, van Vuurden DG, Members of the SIOPE DIPG Network (2017) Development of the SIOPE DIPG network, registry and imaging repository: a collaborative effort to optimize research into a rare and lethal disease. J Neuro-Oncol 132(2):255–266CrossRef Veldhuijzen van Zanten SEM, Baugh J, Chaney B, De Jongh D, Sanchez Aliaga E, Barkhof F, Noltes J, De Wolf R, Van Dijk J, Cannarozzo A, Damen-Korbijn CM, Lieverst JA, Colditz N, Hoffmann M, Warmuth-Metz M, Bison B, Jones DTW, Sturm D, Gielen GH, Jones C, Hulleman E, Calmon R, Castel D, Varlet P, Giraud G, Slavc I, Van Gool S, Jacobs S, Jadrijevic-Cvrlje F, Sumerauer D, Nysom K, Pentikainen V, Kivivuori SM, Leblond P, Entz-Werle N, von Bueren AO, Kattamis A, Hargrave DR, Hauser P, Garami M, Thorarinsdottir HK, Pears J, Gandola L, Rutkauskiene G, Janssens GO, Torsvik IK, Perek-Polnik M, Gil-da-Costa MJ, Zheludkova O, Shats L, Deak L, Kitanovski L, Cruz O, Morales La Madrid A, Holm S, Gerber N, Kebudi R, Grundy R, Lopez-Aguilar E, Zapata-Tarres M, Emmerik J, Hayden T, Bailey S, Biassoni V, Massimino M, Grill J, Vandertop WP, Kaspers GJL, Fouladi M, Kramm CM, van Vuurden DG, Members of the SIOPE DIPG Network (2017) Development of the SIOPE DIPG network, registry and imaging repository: a collaborative effort to optimize research into a rare and lethal disease. J Neuro-Oncol 132(2):255–266CrossRef
8.
Zurück zum Zitat Cooney T, Lane A, Bartels U, Bouffet E, Goldman S, Leary SES, Foreman NK, Packer RJ, Broniscer A, Minturn JE, Shih CS, Chintagumpala M, Hassall T, Gottardo NG, Dholaria H, Hoffman L, Chaney B, Baugh J, Doughman R, Leach JL, Jones BV, Fouladi M, Warren KE, Monje M (2017) Contemporary survival endpoints: an International Diffuse Intrinsic Pontine Glioma Registry study.Neuro. Oncol 19(9):1279–1280 Cooney T, Lane A, Bartels U, Bouffet E, Goldman S, Leary SES, Foreman NK, Packer RJ, Broniscer A, Minturn JE, Shih CS, Chintagumpala M, Hassall T, Gottardo NG, Dholaria H, Hoffman L, Chaney B, Baugh J, Doughman R, Leach JL, Jones BV, Fouladi M, Warren KE, Monje M (2017) Contemporary survival endpoints: an International Diffuse Intrinsic Pontine Glioma Registry study.Neuro. Oncol 19(9):1279–1280
9.
Zurück zum Zitat Eisele SC, Reardon DA (2016) Adult brainstem gliomas. Cancer 122(18):2799–2809CrossRef Eisele SC, Reardon DA (2016) Adult brainstem gliomas. Cancer 122(18):2799–2809CrossRef
10.
Zurück zum Zitat Kesari S, Kim RS, Markos V, Drappatz J, Wen PY, Pruitt AA (2008) Prognostic factors in adult brainstem gliomas: a multicenter, retrospective analysis of 101 cases. J Neuro-Oncol 88:175–183CrossRef Kesari S, Kim RS, Markos V, Drappatz J, Wen PY, Pruitt AA (2008) Prognostic factors in adult brainstem gliomas: a multicenter, retrospective analysis of 101 cases. J Neuro-Oncol 88:175–183CrossRef
11.
Zurück zum Zitat Hundsberger T, Tonder M, Hottinger A, Brügge D, Roelcke U, Putora PM, Stupp R, Weller M (2014) Clinical management and outcome of histologically verified adult brainstem gliomas in Switzerland: a retrospective analysis of 21 patients. J Neuro-Oncol 118:321–328CrossRef Hundsberger T, Tonder M, Hottinger A, Brügge D, Roelcke U, Putora PM, Stupp R, Weller M (2014) Clinical management and outcome of histologically verified adult brainstem gliomas in Switzerland: a retrospective analysis of 21 patients. J Neuro-Oncol 118:321–328CrossRef
12.
Zurück zum Zitat Theeler BJ, Ellezam B, Melguizo-Gavilanes I, de Groot JF, Mahajan A, Aldape KD, Bruner JM, Puduvalli VK (2015) Adult brainstem gliomas: correlation of clinical and molecular features. J Neurol Sci 353:92–97CrossRef Theeler BJ, Ellezam B, Melguizo-Gavilanes I, de Groot JF, Mahajan A, Aldape KD, Bruner JM, Puduvalli VK (2015) Adult brainstem gliomas: correlation of clinical and molecular features. J Neurol Sci 353:92–97CrossRef
13.
Zurück zum Zitat Reithmeier T, Kuzeawu A, Hentschel B, Loeffler M, Trippel M, Nikkhah G (2014) Retrospective analysis of 104 proven adult brainstem gliomas: clinical symptoms, therapeutic approaches and prognostic factors. BMC Cancer 14:115–122CrossRef Reithmeier T, Kuzeawu A, Hentschel B, Loeffler M, Trippel M, Nikkhah G (2014) Retrospective analysis of 104 proven adult brainstem gliomas: clinical symptoms, therapeutic approaches and prognostic factors. BMC Cancer 14:115–122CrossRef
14.
Zurück zum Zitat Wagner S, Benesch M, Berthold F, Gnekow AK, Rutkowski S, Strater R, Warmuth-Metz M, Kortmann RD, Pitsch T, Wolff JEA (2006) Secondary dissemination in children with high-grade malignant gliomas and diffuse intrinsic pontine gliomas. Br J Cancer 95:991–997CrossRef Wagner S, Benesch M, Berthold F, Gnekow AK, Rutkowski S, Strater R, Warmuth-Metz M, Kortmann RD, Pitsch T, Wolff JEA (2006) Secondary dissemination in children with high-grade malignant gliomas and diffuse intrinsic pontine gliomas. Br J Cancer 95:991–997CrossRef
Metadaten
Titel
Adult brainstem glioma: a multicentre retrospective analysis of 47 Italian patients
verfasst von
Andrea Rigamonti
Giorgia Simonetti
Antonio Silvani
Roberta Rudà
Federica Franchino
Veronica Villani
Andrea Pace
Rossella Merli
Maura Servida
Alberto Picca
Giulia Berzero
Alfonso Cerase
Ivano Chiarotti
Giannantonio Spena
Andrea Salmaggi
On behalf of the neurooncology group of SNO (Society of Hospital Neurosciences, Italy)
Publikationsdatum
21.09.2020
Verlag
Springer International Publishing
Erschienen in
Neurological Sciences / Ausgabe 5/2021
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-020-04725-7

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