Changing incidence and improved survival of gliomas

Ho, Vincent K.Y.; Reijneveld, Jaap C.; Enting, Roelien H.; Bienfait, Henri Paul; Robe, Pierre A.; Baumert, Brigitta G.; Visser, Otto

doi:10.1016/j.ejca.2014.05.019

Cited by 201 publications

(175 citation statements)

References 39 publications

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“…This corresponds with the incidence pattern for adult GBM patients in the Dutch population [46]. In that study, the incidence was accompanied by a decrease in other subtypes including anaplastic astrocytomas and astrocytomas with unknown malignancy grade, and the authors speculate whether availability of TMZ had increased identification of GBMs.…”

Section: Increased Incidence Of Glioblastomasupporting

confidence: 58%

Does the choice of antiepileptic drug affect survival in glioblastoma patients?

et al. 2016

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Patients with glioblastoma (GBM) often suffer from symptomatic epilepsy. Older antiepileptic drugs (AEDs) which affect the enzyme system cytochrome P450 have been in extensive use, but there is an increasing focus on interactions with other drugs. This study investigated whether newer AEDs with little or no enzyme effect are increasingly preferred. Previous research has indicated that valproate improves survival in GBM. We investigated the impact of AEDs on overall survival in GBM patients. All GBM patients diagnosed in Norway 2004-2010 were included through a linkage of national registries, and follow-up data on the malignancy and drug usage were analyzed. In a multivariate cox proportional-hazards regression, AEDs were adjusted for each other and for relevant factors. Immortal time bias was eliminated with time-dependent variables. The study population was 1263 patients with histologically confirmed GBM. Carbamazepine was the most frequently prescribed AED to patients diagnosed with GBM during 2004-2006, while levetiracetam was increasingly prescribed to patients diagnosed later. Taking AEDs on a reimbursement code of epilepsy was not beneficial for survival. None of the six AEDs valproate, levetiracetam, carbamazepine, oxcarbazepine, lamotrigine or phenytoin significantly altered overall survival. There has been a shift in the prescriptions of AEDs to GBM patients from older to newer AEDs over time. We found no significant survival benefit in GBM patients neither from treatment with AEDs for epilepsy in general, nor from the usage of six separate AEDs.

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Section: Increased Incidence Of Glioblastomasupporting

confidence: 58%

Does the choice of antiepileptic drug affect survival in glioblastoma patients?

et al. 2016

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“…Patients, recipients of GBM-donor organ that undergo immunosuppressive regimen, have been described to develop lethal extracranial GBM metastasis, related to CTC (Jimsheleishvili et al, 2014). It is well known how GBMs are a heterogeneous disease, and four molecular subclasses have been identified (Brennan et al, 2013;Parker et al, 2015). Indeed, GBM subtype could probably be linked to invasiveness; the authors hypothesized and sustained with very early evidence that mesenchymal phenotype can favor extraneural GBM.…”

Section: Commentmentioning

confidence: 88%

“…Although circulating brain tumor cells (CTC) have been recently described (Muller et al, 2014), extracranial GBM metastasis are exceptional, perhaps because of the peculiar neuronal milieu and the presence of an efficient immune response. Patients, recipients of GBM-donor organ that undergo immunosuppressive regimen, have been described to develop lethal extracranial GBM metastasis, related to CTC (Jimsheleishvili et al, 2014). It is well known how GBMs are a heterogeneous disease, and four molecular subclasses have been identified (Brennan et al, 2013;Parker et al, 2015).…”

Section: Commentmentioning

confidence: 99%

Extraneural metastases in glioblastoma patients: two cases with YKL-40-positive glioblastomas and a meta-analysis of the literature

Anghileri

Castiglione²,

Nunziata³

et al. 2015

Neurosurg Rev

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Glioblastoma (GBM) are high-grade gliomas that severely impact on overall survival (OS). GBM cell motility and the breakdown of the blood-brain barrier could favor GBM cell communication with the systemic circulation. In spite of this, extracranial GBM metastases are rare. Here, we describe two YKL-40-positive GBM patients with extra-CNS (central nervous system) metastases, and we present a meta-analysis of 94 cases. The analysis concluded that extra-CNS metastases occurred 8.5 months after first GBM diagnosis and OS was 12 months; surgical GBM excision was associated at a longer interval to extra-CNS metastasis than biopsy only, and even longer if followed by radiotherapy and chemotherapy. Both our case reports were adult males who developed extra-CNS, YKL-40-positive metastases at lymph nodes, lung and subcutaneous sites, after 86 and 24 months from initial diagnosis of GBM. At first GBM local recurrence, they were treated with bevacizumab (BV), an anti-vascular endothelial growth factor antibody. They died after 4 and 1 month from the occurrence of metastases. Both cases expressed YKL-40 and lacked EGFR amplification, suggesting a mesenchymal phenotype, and maintained such profile at extra-CNS recurrence; they did not show MGMT promoter methylation, IDH1/2 mutations, or c-Met upregulation. Our two cases and the meta-analysis support the idea that prolonged survival of GBM patients increases the probability of GBM cells shedding to lymphatic and hematic system. Interestingly, the present two cases showed the features of mesenchymal profile, usually related with worst prognosis that was maintained in extracranial metastases.

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“…All of the above-mentioned scenarios warrant investigation, which will include diagnostic imaging, due to their potentially dire consequences Re-growth of tumour is anticipated among children with high-grade lesions, especially glioblastomas [81,146,247]. However, although long-term prognoses remain dismal, small improvements in survival times are being reported even among patients with GBMs, relating to advanced surgical techniques, the introduction of real-time, intra-operative imaging and brain mapping, and combining TMZ with radiation therapy [147,189,[247][248][249][250]. Recall that in one study in which eleven of the 20 children had either a grade III or grade IV lesion, including two GBMs, a grade IV PNET, and a grade IV neuroblastoma, all 20 patients lived beyond four years [35].…”

Section: Implications Of Post-operative Seizuresmentioning

confidence: 99%