Juliana Arcangelo Di Vita Carvalho1, Caroline Chaul de Lima Barbosa2,3, Olavo Feher2,3, Marcos Vinicius Calfat Maldaun4,5, Veridiana Pires de Camargo2,3, Fabio Y Moraes6,7, Gustavo Nader Marta8,7. 1. Department of Radiation Oncology - Oncologia Centenário São Leopoldo - Rio Grande do Sul, Brasil. 2. Department of Radiology and Oncology - Clinical Oncology Unit; Faculdade de Medicina da Universidade de São Paulo - Instituto do Câncer do Estado de São Paulo (Icesp); Sao Paulo, Brasil. 3. Department of Clinical Oncology - Hospital Sírio-Libanês; Sao Paulo, Brasil. 4. Division of Neurosurgery, Hospital Sírio-Libanês; Sao Paulo, Brasil. 5. Division of Neurosurgery, Santa Paula Hospital, São Paulo, SP, Brasil. 6. Department of Oncology, Division of Radiation Oncology, Queen's University - Kingston Health Science Centre, Kingston, ON, Canada. 7. Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brasil. 8. Department of Radiology and Oncology, Division of Radiation Oncology, Instituto do Câncer do Estado de São Paulo (Icesp), Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brasil.
Abstract
INTRODUCTION: Glioblastoma (GBM) is the most frequent primary malignant tumor from the central nervous system in adults. However, the presence of systemic metastasis is an extremely rare event. The objective of this study was to review the literature, evaluating the possible biological mechanisms related to the occurrence of systemic metastasis in patients diagnosed with GBM. RESULTS: The mechanisms that may be related to GBM systemic dissemination are the blood-brain barrier breach, often seen in GBM cases, by the tumor itself or by surgical procedures, gaining access to blood and lymphatic vessels, associated with the acquisition of mesenchymal features of invasiveness, resistance to the immune mechanisms of defense and hostile environment through quiescence. CONCLUSIONS: Tumor cells must overcome many obstacles until the development of systemic metastasis. The physiologic mechanisms are not completely clear. Although not fully understood, the pathophysiological understanding of the mechanisms that may be associated with the systemic spread is salutary for a global understanding of the disease. In addition, this knowledge may be used as a basis for a therapy to be performed in patients diagnosed with GBM distant metastasis.
INTRODUCTION:Glioblastoma (GBM) is the most frequent primary malignant tumor from the central nervous system in adults. However, the presence of systemic metastasis is an extremely rare event. The objective of this study was to review the literature, evaluating the possible biological mechanisms related to the occurrence of systemic metastasis in patients diagnosed with GBM. RESULTS: The mechanisms that may be related to GBM systemic dissemination are the blood-brain barrier breach, often seen in GBM cases, by the tumor itself or by surgical procedures, gaining access to blood and lymphatic vessels, associated with the acquisition of mesenchymal features of invasiveness, resistance to the immune mechanisms of defense and hostile environment through quiescence. CONCLUSIONS:Tumor cells must overcome many obstacles until the development of systemic metastasis. The physiologic mechanisms are not completely clear. Although not fully understood, the pathophysiological understanding of the mechanisms that may be associated with the systemic spread is salutary for a global understanding of the disease. In addition, this knowledge may be used as a basis for a therapy to be performed in patients diagnosed with GBM distant metastasis.
Authors: Joshua R D Pearson; Stefania Cuzzubbo; Simon McArthur; Lindy G Durrant; Jason Adhikaree; Chris J Tinsley; A Graham Pockley; Stephanie E B McArdle Journal: Front Immunol Date: 2020-10-15 Impact factor: 7.561