|Table of Contents|

Pathological features and recurrence patterns of multiple high-grade gliomas

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 05
Page:
843-847
Research Field:
Publishing date:

Info

Title:
Pathological features and recurrence patterns of multiple high-grade gliomas
Author(s):
ZHAO Yongrui1; WANG Leiming2; CHEN Yidong1; GAO Ying1; XU Jiankun1
1.Department of Radiation Oncology;2.Department of Pathology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China.
Keywords:
high-grade glioma; multiple; pathology; recurrence
PACS:
R730.264
DOI:
10.3969/j.issn.1672-4992.2023.05.011
Abstract:
Objective：To explore the pathological characteristics and recurrence patterns of multiple high-grade gliomas(M-HGGs).Methods:Twenty-six patients with M-HGGs who underwent treatment from August 2020 to April 2022 were retrospectively analyzed,including pathological features radiological features treatment methods recurrence patterns.Results:All 26 cases underwent surgical treatment.Pathology showed 24 cases of IDH wild-type and 2 cases of IDH mutation.There were 8 cases(30.8%) of patients withs MGMT promoter methylation.Immunohistochemistry showed that 25 cases were p53 overexpression and 1 case was negative.The average of Ki-67(40.19±6.99)%.Twenty-four patients received postoperative adjuvant therapy,and two patients received conservative treatment.The follow-up time was 3~20 months.Nineteen patients experienced recurrence with a median progression-free survival(PFS) of 6 months,of which 14 patients(73.7%) had local recurrence and five patients had distant recurrence in the brain.The extent of surgical resection and postoperative adjuvant therapy were associated with a longer PFS in Kaplan-Meier survival analyses(P=0.001,P=0.000).Multivarate analysis also showed that the extent of surgical recsection and postoperative adjuvant therapy were prognostic factor of improving PFS(P=0.006,P=0.031).Conclusion:M-HGGs are mostly IDH wild-type and usually have poor prognostic indicators such as p53 overexpression,and a high Ki-67 index.The most common recurrence pattern of M-HGGs is local recurrence,the extent of surgical resection and postoperative adjuvant therapy may affect the survival of patients with M-HGGs.

References:

[1]LOUIS DN,PERRY A,WESSELING P,et al.The 2021 WHO classification of tumors of the central nervous system:a summary ［J］.Neuro Oncol,2021,23(8):1231-1251.
[2]BATZDORF U,MALAMUD N.The problem of multicentric gliomas ［J］.J Neurosurg,1963,20:122-136.
[3] PICART T,LE CORRE M,CHAN-SENG E,et al.The enigma of multicentric glioblastoma:physiopathogenic hypothesis and discussion about two cases ［J］.Br J Neurosurg,2018,32(6):610-613.
[4]HAQUE W,THONG Y,VERMA V,et al.Patterns of management and outcomes of unifocal versus multifocal glioblastoma ［J］.J Clin Neurosci,2020,74:155-159.
[5]CARLO D,CAGNAZZO F,BENEDETTO N,et al.Multiple high-grade gliomas:epidemiology,management and outcome.A systematic review and meta-analysis ［J］.Neurosurg Rev,2019,42(2):263-275.
[6]TENSAOUTI F,KHALIFA J,LUSQUE A,et al.Response assessment in neuro-oncology criteria,contrast enhancement and perfusion MRI for assessing progression in glioblastoma ［J］.Neuroradiology,2017,59(10):1013-1120.
[7]WALLNER KE,GALICICH JH,KROL G,et al.Patterns of failure following treatment for glioblastoma multiforme and anaplastic astrocytoma ［J］.Int J Radiat Oncol Biol Phys,1989,16(6):1405-1409.
[8]THOMAS RP,XU LW,LOBER RM,et al.The incidence and significance of multiple lesions in glioblastoma ［J］.J Neurooncol,2013,112(1):91-97.
[9]PATIL CG,YI A,ELRAMSISY A,et al.Prognosis of patients with multifocal glioblastoma:a case-control study ［J］.J Neurosurg,2012,117(4):705-711.
[10]LASOCKI A,GAILLARD F,TACEY M,et al.Multifocal and multicentric glioblastoma:Improved characterisation with FLAIR imaging and prognostic implications ［J］.J Clin Neurosci,2016,31:92-98.
[11]PAULSSON AK,HOLMES JA,PEIFFER AM,et al.Comparison of clinical outcomes and genomic characteristics of single focus and multifocal glioblastoma ［J］.J Neurooncol,2014,119(2):429-435.
[12]ABOUELARDAT K,SEIFERT M,BECKER K,et al.Comprehensive molecular characterization of multifocal glioblastoma proves its monoclonal origin and reveals novel insights into clonal evolution and heterogeneity of glioblastomas ［J］.Neuro Oncol,2017,19(4):546-557.
[13]LOMBARDI G,DELLA PUPPA A,GARDIMAN MP,et al.Discordance of IDH mutational status between lesions in an adult patientwith multifocal glioma ［J］.Neuro Oncol,2018,20(8):1142-1143.
[14]GALUPPINI F,OPOCHER E,TABORI U,et al.Concomitant IDH wild-type glioblastoma and IDH1-mutant anaplastic astrocytoma in a patient with constitutional mismatch repair deficiency syndrome ［J］.Neuropathol Appl Neurobiol,2018,44(2):233-239.
[15] ECKEL-PASSOW JE,LACHANCE DH,MOLINARO AM,et al.Glioma groups based on 1p/19q,IDH and TERT promoter mutations in tumors ［J］.N Engl J Med,2015,372(26):2499-2508.
[16] LAM N,CHAMBERS C.Temozolomide plus radiotherapy for glioblastoma in a Canadian province:efficacy versus effectiveness and the impact of O6-methylguanine-DNA-methyltransferase promoter methylation ［J］.J Oncol Pharm Pract,2012,18(2):229-238.
[17] LIU Q,LIU Y,LI W,et al.Genetic,epigenetic,and molecular landscapes of multifocal and multicentric glioblastoma ［J］.Acta Neuropathol,2015,130(4):587-597.
[18] ARMOCIDA D,PESCE A,GIAMMARCO FD,et al.Histological,molecular,clinical and outcomes characteristics of multiple lesion glioblastoma.A retrospective monocentric study and review of literature ［J］.Neurocirugia,2021,32(3):114-123.
[19]DONO A,WANG E,LOPEZ-RIVERA V,et al.Molecular characteristics and clinical features of multifocal glioblastoma ［J］.J Neurooncol,2020,148(2):389-397.
[20]TUNTHANATHIP T,SANGKHATHAT S,TANVEJSILP P,et al.The clinical characteristics and prognostic factors of multiple lesions in glioblastomas ［J］.Clin Neurol Neurosurg,2020,195:105891.
[21] LAHMI L,IDBAIH A,CAMPO E,et al.Whole brain radiotherapy with concurrent temozolomide in multifocal and/or multicentric newly diagnosed glioblastoma ［J］.J Clin Neurosci,2019,68:39-44.
[22] FRISO F,RUCCI P,ROSETTI V,et al.Is there a role for surgical resection of multifocal glioblastoma?A retrospective analysis of 100 patients ［J］.Neurosurgery,2021,89(6):1042-1051.
[23]LONG D,HEATH RN,SHAH AH,et al.Resection versus biopsy in the treatment of multifocal glioblastoma:a weighted survival analysis ［J］.J Neurooncol,2020,148(1):155-164.
[24] KYRITSIS AP,BONDY ML,XIAO M,et al.Germline p53 gene mutations in subsets of glioma patients ［J］.J Natl Cancer Inst,1994,86(5):344-349.
[25]李建瑞,许强,刘高平,等.多发脑胶质瘤白质受累部位特征的MRI表现［J］.中华医学杂志,2022,102(17):1311-1314. LI JR,XU Q,LIU GP,et al.Characteristics of the white matter involvement sites on MRI in patients with multiple gliomas ［J］.Natl Med J China,2022,102(17):1311-1314.
[26] KASPER J,HILBERT N,WENDE T,et al.On the prognosis of multifocal glioblastoma:An evaluation incorporating volumetric MRI ［J］.Curr Oncol,2021,28(2):1437-1446.
[27]AMPIL F,BURTON GV,GONZALEZ-TOLEDO E,et al.Do we need whole brain irradiation in multifocal or multicentric high-grade cerebral gliomas?Review of cases and the literature ［J］.J Neurooncol,2007,85(3):353-355.
[28] SYED M,MOHR A,RIEBER J,et al.Survival and recurrence patterns of multifocal glioblastoma after radiation therapy ［J］.Cancer Manag Res,2018,10:4229-4235.

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Last Update: 2023-01-31