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09.11.2018 | Clinical Study

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

Zeitschrift:
Journal of Neuro-Oncology
Autoren:
Ichiyo Shibahara, Ryuta Saito, Yoshinari Osada, Masayuki Kanamori, Yukihiko Sonoda, Toshihiro Kumabe, Shunji Mugikura, Mika Watanabe, Teiji Tominaga
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s11060-018-03036-4) contains supplementary material, which is available to authorized users.

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.

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Zusatzmaterial
Supplementary material 1 (TIF 444 KB)
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Supplementary material 2 (TIF 529 KB)
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Supplementary material 3 (TIF 347 KB)
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Supplementary material 4 (TIF 298 KB)
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Supplementary material 5 (TIF 440 KB)
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Supplementary material 6 (TIF 255 KB)
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Supplementary material 7 (TIF 296 KB)
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Supplementary material 8 (TIF 461 KB)
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Supplementary material 9 (DOCX 14 KB)
11060_2018_3036_MOESM9_ESM.docx
Literatur
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