Pamela Franco1,2, Daniel Delev3, Debora Cipriani4,5, Nicolas Neidert4,5, Elias Kellner5,6, Waseem Masalha4,5, Bianca Mercas4,5, Irina Mader5,7, Peter Reinacher5,8, Astrid Weyerbrock5, Christian Fung4,5, Jürgen Beck4,5, Dieter Henrik Heiland4,5, Oliver Schnell4,5. 1. Department of Neurosurgery, Medical Center - University of Freiburg, Breisacher Straße 64, 79106, Freiburg, BW, Germany. pamela.heiland@uniklinik-freiburg.de. 2. Faculty of Medicine, University of Freiburg, Freiburg, BW, Germany. pamela.heiland@uniklinik-freiburg.de. 3. Department of Neurosurgery, University of Aachen, Aachen, NRW, Germany. 4. Department of Neurosurgery, Medical Center - University of Freiburg, Breisacher Straße 64, 79106, Freiburg, BW, Germany. 5. Faculty of Medicine, University of Freiburg, Freiburg, BW, Germany. 6. Department of Radiology, Medical Centre - University of Freiburg, Freiburg, BW, Germany. 7. Specialist Centre for Radiology, Schoen Clinic, Vogtareuth, BY, Germany. 8. Department of Neurosurgery, Division Stereotactic and Functional Neurosurgery, Medical Center- University of Freiburg, Freiburg, BW, Germany.
Abstract
BACKGROUND: Glioblastoma of the corpus callosum (ccGBM) are rare tumors, with a dismal prognosis marked by a rapid clinical deterioration. For a long time, surgical treatment was not considered beneficial for most patients with such tumors. Recent studies claimed an improved survival for patients undergoing extensive resection, albeit without integration of the molecular profile of the lesions. The purpose of this study was to investigate the effect of biopsy and surgical resection on oncological and functional outcomes in patients with IDH wild-type ccGBM. METHODS: We performed a retrospective analysis of our institution's database of patients having been treated for high-grade glioma between 2005 and 2017. Inclusion criteria were defined as follows: patients older than 18 years, histopathological, and molecularly defined IDH wild-type glioma, major tumor mass (at least 2/3) invading the corpus callosum in the sagittal plane with a uni- or bilateral infiltration of the adjacent lobules. Surgical therapy (resection vs. biopsy), extent of resection according to the remaining tumor volume and adjuvant treatment as well as overall survival and functional outcome using the Karnofsky Performance Score (KPS) were analyzed. RESULTS: Fifty-five patients were included in the study, from which the mean age was 64 years and men (n = 34, 61.8%) were more often affected than women (n = 21, 38.2%). Thirty (54.5%) patients were treated with stereotactic biopsy alone, while 25 patients received tumor resection resulting in 14.5% (n = 8) gross-total resections and 30.9% (n = 17) partial resections. The 2-year survival rate after resection was 30% compared to 7% after biopsy (p = 0.047). The major benefit was achieved in the group with gross-total resection, while partial resection failed to improve survival. Neurological outcome measured by KPS did not differ between both groups either pre- or postoperatively. CONCLUSIONS: Our study suggests that in patients with corpus callosum glioblastoma, gross-total resection prolongs survival without negatively impacting neurological outcome as compared to biopsy.
BACKGROUND: Glioblastoma of the corpus callosum (ccGBM) are rare tumors, with a dismal prognosis marked by a rapid clinical deterioration. For a long time, surgical treatment was not considered beneficial for most patients with such tumors. Recent studies claimed an improved survival for patients undergoing extensive resection, albeit without integration of the molecular profile of the lesions. The purpose of this study was to investigate the effect of biopsy and surgical resection on oncological and functional outcomes in patients with IDH wild-type ccGBM. METHODS: We performed a retrospective analysis of our institution's database of patients having been treated for high-grade glioma between 2005 and 2017. Inclusion criteria were defined as follows: patients older than 18 years, histopathological, and molecularly defined IDH wild-type glioma, major tumor mass (at least 2/3) invading the corpus callosum in the sagittal plane with a uni- or bilateral infiltration of the adjacent lobules. Surgical therapy (resection vs. biopsy), extent of resection according to the remaining tumor volume and adjuvant treatment as well as overall survival and functional outcome using the Karnofsky Performance Score (KPS) were analyzed. RESULTS: Fifty-five patients were included in the study, from which the mean age was 64 years and men (n = 34, 61.8%) were more often affected than women (n = 21, 38.2%). Thirty (54.5%) patients were treated with stereotactic biopsy alone, while 25 patients received tumor resection resulting in 14.5% (n = 8) gross-total resections and 30.9% (n = 17) partial resections. The 2-year survival rate after resection was 30% compared to 7% after biopsy (p = 0.047). The major benefit was achieved in the group with gross-total resection, while partial resection failed to improve survival. Neurological outcome measured by KPS did not differ between both groups either pre- or postoperatively. CONCLUSIONS: Our study suggests that in patients with corpus callosum glioblastoma, gross-total resection prolongs survival without negatively impacting neurological outcome as compared to biopsy.
Entities:
Keywords:
Butterfly glioblastoma; Corpus callosum glioblastoma; Extent of resection; Glioblastoma; IDH status; Molecular diagnosis; Neurosurgery
Authors: Paolo Palmisciano; Gianluca Ferini; Gina Watanabe; Christian Ogasawara; Emal Lesha; Othman Bin-Alamer; Giuseppe E Umana; Kenny Yu; Aaron A Cohen-Gadol; Tarek Y El Ahmadieh; Ali S Haider Journal: Cancers (Basel) Date: 2022-05-19 Impact factor: 6.575
Authors: Rafał Chojak; Marta Koźba-Gosztyła; Katarzyna Słychan; Daniel Gajos; Marek Kotas; Michał Tyliszczak; Bogdan Czapiga Journal: Sci Rep Date: 2021-07-06 Impact factor: 4.379