nach oben

Erschienen in:

09.11.2018 | Clinical Study

Incidence of initial spinal metastasis in glioblastoma patients and the importance of spinal screening using MRI

verfasst von: Ichiyo Shibahara, Ryuta Saito, Yoshinari Osada, Masayuki Kanamori, Yukihiko Sonoda, Toshihiro Kumabe, Shunji Mugikura, Mika Watanabe, Teiji Tominaga

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Intracranial glioblastomas with simultaneous spinal lesions prior to chemoradiation therapy or craniotomy, defined as initial spinal metastasis, are not well understood. Herein, we investigated intracranial glioblastoma and demonstrated the importance of spinal screening using gadolinium enhanced spinal magnetic resonance imaging (Gd-MRI).

Methods

Consecutive adult patients with intracranial glioblastoma were treated between 2010 and 2014 and received spinal screening using Gd-MRI. Spinal screening was performed regardless of spine-related symptoms, and patients presenting with and without initial spinal metastasis (spinal and non-spinal groups, respectively) were compared based on patient demographics, tumor characteristics, radiological and molecular features, and overall survival (OS).

Results

During the study period, 116 glioblastoma cases were treated and 87 of these (76%) underwent spinal screening. Among these patients, 11 (13%) were included in the spinal group, and 76 (87%) were included in the non-spinal group. All patients of the spinal group were free of symptoms related to spinal lesions. Compared with the non-spinal group, intracranial lesions of the spinal group presented higher incidences of intracranial dissemination and were located at subventricular zones (P = 0.0012 and 0.020, respectively). MIB-1 labeling index, molecular alterations such as IDH1 mutation, TERT promoter mutation, and immunoreactivity of ATRX and MGMT did not differ between two groups. OS was significantly shorter in the spinal group than in the non-spinal group (P = 0.0054).

Conclusions

This study revealed a relatively high incidence of spinal metastasis. A subset of glioblastoma patients benefited from spinal screening, through which early detection of asymptomatic spinal metastasis was achieved.

Nur mit Berechtigung zugänglich

Wick W, Stupp R, Beule AC, Bromberg J, Wick A, Ernemann U, Platten M, Marosi C, Mason WP, van den Bent M, Weller M, Rorden C, Karnath HO (2008) A novel tool to analyze MRI recurrence patterns in glioblastoma. Neuro Oncol 10(6):1019–1024. https://doi.org/10.1215/15228517-2008-058 CrossRefPubMedPubMedCentral

Shibahara I, Sonoda Y, Saito R, Kanamori M, Yamashita Y, Kumabe T, Watanabe M, Suzuki H, Watanabe T, Ishioka C, Tominaga T (2013) The expression status of CD133 is associated with the pattern and timing of primary glioblastoma recurrence. Neuro Oncol 15(9):1151–1159. https://doi.org/10.1093/neuonc/not066 CrossRefPubMedPubMedCentral

Lawton CD, Nagasawa DT, Yang I, Fessler RG, Smith ZA (2012) Leptomeningeal spinal metastases from glioblastoma multiforme: treatment and management of an uncommon manifestation of disease. J Neurosurg Spine 17(5):438–448. https://doi.org/10.3171/2012.7.SPINE12212 CrossRefPubMed

Saito R, Kumabe T, Jokura H, Shirane R, Yoshimoto T (2003) Symptomatic spinal dissemination of malignant astrocytoma. J Neurooncol 61(3):227–235CrossRefPubMed

Lin L, Innerfield CE, Cuccurullo SJ (2014) Symptomatic spinal leptomeningeal metastasis from intracranial glioblastoma multiforme. Am J Phys Med Rehabil 93(9):838–839. https://doi.org/10.1097/PHM.0b013e3182a51b90 CrossRefPubMed

Alatakis S, Malham GM, Thien C (2001) Spinal leptomeningeal metastasis from cerebral glioblastoma multiforme presenting with radicular pain: case report and literature review. Surg Neurol 56(1):33–37 (discussion 37–38)CrossRefPubMed

Onda K, Tanaka R, Takahashi H, Takeda N, Ikuta F (1989) Cerebral glioblastoma with cerebrospinal fluid dissemination: a clinicopathological study of 14 cases examined by complete autopsy. Neurosurgery 25(4):533–540CrossRefPubMed

Fujimura M, Kumabe T, Jokura H, Shirane R, Yoshimoto T, Tominaga T (2004) Intractable vomiting as an early clinical symptom of cerebrospinal fluid seeding to the fourth ventricle in patients with high-grade astrocytoma. J Neurooncol 66(1–2):209–216CrossRefPubMed

Kanamori M, Kumabe T, Sonoda Y, Nishino Y, Watanabe M, Tominaga T (2009) Predictive factors for overall and progression-free survival, and dissemination in oligodendroglial tumors. J Neurooncol 93(2):219–228. https://doi.org/10.1007/s11060-008-9762-7 CrossRefPubMed

10.

Kato H, Fujimura M, Kumabe T, Ishioka C, Kanamaru R, Yoshimoto T (2004) PTEN gene mutation and high MIB-1 labeling index may contribute to dissemination in patients with glioblastoma. J Clin Neurosci 11(1):37–41CrossRefPubMed

11.

Saito R, Kumabe T, Jokura H, Yoshimoto T (2002) Fatal hemorrhage after radiochemotherapy for leptomeningeal dissemination of glioma: report of two cases. Surg Neurol 57(1):46–48CrossRefPubMed

12.

Saito R, Kumabe T, Kanamori M, Sonoda Y, Tominaga T (2017) Distant recurrences limit the survival of patients with thalamic high-grade gliomas after successful resection. Neurosurg Rev 40(3):469–477. https://doi.org/10.1007/s10143-016-0804-x CrossRefPubMed

13.

Inoue T, Endo T, Nakamura T, Shibahara I, Endo H, Tominaga T (2018) Expression of CD133 as a putative prognostic biomarker to predict intracranial dissemination of primary spinal cord astrocytoma. World Neurosurg 110:e715–e726. https://doi.org/10.1016/j.wneu.2017.11.089 CrossRefPubMed

14.

Denicolai E, Tabouret E, Colin C, Metellus P, Nanni I, Boucard C, Tchoghandjian A, Meyronet D, Baeza-Kallee N, Chinot O, Figarella-Branger D (2016) Molecular heterogeneity of glioblastomas: does location matter? Oncotarget 7(1):902–913. https://doi.org/10.18632/oncotarget.6433 CrossRefPubMed

15.

Lim DA, Cha S, Mayo MC, Chen MH, Keles E, VandenBerg S, Berger MS (2007) Relationship of glioblastoma multiforme to neural stem cell regions predicts invasive and multifocal tumor phenotype. Neuro Oncol 9(4):424–429. https://doi.org/10.1215/15228517-2007-023 CrossRefPubMedPubMedCentral

16.

Sonoda Y, Saito R, Kanamori M, Kumabe T, Uenohara H, Tominaga T (2014) The association of subventricular zone involvement at recurrence with survival after repeat surgery in patients with recurrent glioblastoma. Neurol Med Chir (Tokyo) 54(4):302–309CrossRef

17.

Elliott JP, Keles GE, Waite M, Temkin N, Berger MS (1994) Ventricular entry during resection of malignant gliomas: effect on intracranial cerebrospinal fluid tumor dissemination. J Neurosurg 80(5):834–839. https://doi.org/10.3171/jns.1994.80.5.0834 CrossRefPubMed

18.

Sonoda Y, Yokosawa M, Saito R, Kanamori M, Yamashita Y, Kumabe T, Watanabe M, Tominaga T (2010) O (6)-Methylguanine DNA methyltransferase determined by promoter hypermethylation and immunohistochemical expression is correlated with progression-free survival in patients with glioblastoma. Int J Clin Oncol. https://doi.org/10.1007/s10147-010-0065-6 CrossRefPubMed

19.

Shibahara I, Sonoda Y, Suzuki H, Mayama A, Kanamori M, Saito R, Suzuki Y, Mashiyama S, Uenohara H, Watanabe M, Kumabe T, Tominaga T (2017) Glioblastoma in neurofibromatosis 1 patients without IDH1, BRAF V600E, and TERT promoter mutations. Brain Tumor Pathol. https://doi.org/10.1007/s10014-017-0302-z CrossRefPubMed

20.

Shibahara I, Sonoda Y, Kanamori M, Saito R, Yamashita Y, Kumabe T, Watanabe M, Suzuki H, Kato S, Ishioka C, Tominaga T (2012) IDH1/2 gene status defines the prognosis and molecular profiles in patients with grade III gliomas. Int J Clin Oncol 17(6):551–561. https://doi.org/10.1007/s10147-011-0323-2 CrossRefPubMed

21.

Sonoda Y, Kumabe T, Nakamura T, Saito R, Kanamori M, Yamashita Y, Suzuki H, Tominaga T (2009) Analysis of IDH1 and IDH2 mutations in Japanese glioma patients. Cancer Sci 100(10):1996–1998. https://doi.org/10.1111/j.1349-7006.2009.01270.x CrossRefPubMed

22.

Eckel-Passow JE, Lachance DH, Molinaro AM, Walsh KM, Decker PA, Sicotte H, Pekmezci M, Rice T, Kosel ML, Smirnov IV, Sarkar G, Caron AA, Kollmeyer TM, Praska CE, Chada AR, Halder C, Hansen HM, McCoy LS, Bracci PM, Marshall R, Zheng S, Reis GF, Pico AR, O’Neill BP, Buckner JC, Giannini C, Huse JT, Perry A, Tihan T, Berger MS, Chang SM, Prados MD, Wiemels J, Wiencke JK, Wrensch MR, Jenkins RB (2015) Glioma groups based on 1p/19q, IDH, and TERT promoter mutations in tumors. N Engl J Med 372(26):2499–2508. https://doi.org/10.1056/NEJMoa1407279 CrossRefPubMedPubMedCentral

23.

Pietschmann S, von Bueren AO, Henke G, Kerber MJ, Kortmann RD, Muller K (2014) An individual patient data meta-analysis on characteristics, treatments and outcomes of the glioblastoma/gliosarcoma patients with central nervous system metastases reported in literature until 2013. J Neurooncol 120(3):451–457. https://doi.org/10.1007/s11060-014-1596-x CrossRefPubMed

24.

Pezeshkpour GH, Henry JM, Armbrustmacher VW (1984) Spinal metastases. A rare mode of presentation of brain tumors. Cancer 54(2):353–356CrossRefPubMed

25.

Vertosick FT Jr, Selker RG (1990) Brain stem and spinal metastases of supratentorial glioblastoma multiforme: a clinical series. Neurosurgery 27(4):516–521 (discussion 521–512)CrossRefPubMed

26.

Ravindran K, Gaillard F, Lasocki A (2017) Distant spread of a supratentorial glioblastoma to the spinal cord. J Clin Neurosci 38:56–57. https://doi.org/10.1016/j.jocn.2016.11.010 CrossRefPubMed

27.

Shapiro MD (2006) MR imaging of the spine at 3T. Magn Reson Imaging Clin N Am 14(1):97–108. https://doi.org/10.1016/j.mric.2006.01.005 CrossRefPubMed

28.

Rodegerdts EA, Boss A, Riemarzik K, Lichy M, Schick F, Claussen CD, Schlemmer HP (2006) 3D imaging of the whole spine at 3T compared to 1.5T: initial experiences. Acta Radiol 47(5):488–493CrossRefPubMed

29.

de Eulate-Beramendi SA, Pina-Batista KM, Rodrigo V, Torres-Rivas HE, Rial-Basalo JC (2016) Multicentric spinal cord and brain glioblastoma without previous craniotomy. Surg Neurol Int 7(Suppl 17):S492–S494. https://doi.org/10.4103/2152-7806.185785 CrossRefPubMedPubMedCentral

30.

Pohar S, Taylor W, Chandan VS, Shah H, Sagerman RH (2004) Primary presentation of glioblastoma multiforme with leptomeningeal metastasis in the absence of previous craniotomy: a case report. Am J Clin Oncol 27(6):640–641CrossRefPubMed

31.

Rivero-Garvia M, Boto GR, Perez-Zamarron A, Gutierrez-Gonzalez R, Ahmad IS, Martinez A (2008) Spinal cord and brain glioblastoma multiforme without previous craniotomy. J Neurosurg Spine 8(6):601. https://doi.org/10.3171/SPI/2008/8/6/601 CrossRefPubMed

32.

Adeberg S, Konig L, Bostel T, Harrabi S, Welzel T, Debus J, Combs SE (2014) Glioblastoma recurrence patterns after radiation therapy with regard to the subventricular zone. Int J Radiat Oncol Biol Phys 90(4):886–893. https://doi.org/10.1016/j.ijrobp.2014.07.027 CrossRefPubMed

33.

Eriksson PS, Perfilieva E, Bjork-Eriksson T, Alborn AM, Nordborg C, Peterson DA, Gage FH (1998) Neurogenesis in the adult human hippocampus. Nat Med 4(11):1313–1317. https://doi.org/10.1038/3305 CrossRefPubMed

34.

Shahideh M, Fallah A, Munoz DG, Loch Macdonald R (2012) Systematic review of primary intracranial glioblastoma multiforme with symptomatic spinal metastases, with two illustrative patients. J Clin Neurosci 19(8):1080–1086. https://doi.org/10.1016/j.jocn.2011.09.024 CrossRefPubMed

35.

Maslehaty H, Cordovi S, Hefti M (2011) Symptomatic spinal metastases of intracranial glioblastoma: clinical characteristics and pathomechanism relating to GFAP expression. J Neurooncol 101(2):329–333. https://doi.org/10.1007/s11060-010-0257-y CrossRefPubMed

Titel: Incidence of initial spinal metastasis in glioblastoma patients and the importance of spinal screening using MRI
verfasst von: Ichiyo Shibahara
Ryuta Saito
Yoshinari Osada
Masayuki Kanamori
Yukihiko Sonoda
Toshihiro Kumabe
Shunji Mugikura
Mika Watanabe
Teiji Tominaga
Publikationsdatum: 09.11.2018
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 2/2019
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-03036-4

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2019

Paraneoplastic neurological syndromes: a single institution 10-year case series

Neuropsychological outcomes of patients with low-grade glioma diagnosed during the first year of life

Neurocognitive function, performance status, and quality of life in pediatric intracranial germ cell tumor survivors

Increased compliance with tumor treating fields therapy is prognostic for improved survival in the treatment of glioblastoma: a subgroup analysis of the EF-14 phase III trial

Trans-eyebrow supraorbital keyhole approach in suprasellar and third ventricular craniopharyngioma surgery: the experience of 27 cases and a literature review