Long term follow-up and outcomes in adult patients with thalamic gliomas

Li, Zhiqi; Wu, Hanfeng; Wu, Biwu; Lyu, Jiaying; Liu, Yikui; Tang, Chao; Hua, Wei; Hu, Shukun; Wang, Yang; Zhang, Yi

doi:10.1016/j.clineuro.2020.105888

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…Intensity-modulated radiotherapy and radiosurgery showed worse survivals but lower rates of post-treatment complications compared to surgical resection. They were associated with reasonable local control in LGGs, but rapid tumor proliferation and clinical deterioration in HGGs related to the aggressiveness tumor biology [10,32]. The role of LITT has also been explored for deep/unresectable and chemo/radioresistant gliomas [7,9,16,29].…”

Section: Discussionmentioning

confidence: 99%

“…The heterogeneity of outcome data precluded a meta-analysis, univariate/multivariate regression analyses and Cox-regression analyses. Some individual patient data could not be extracted in five studies, limiting our sample size and pooled analysis [1,6,10,18,22]. Due to the limited granular data on molecular analyses other than H3 K27M, we could not analyze their impact on patients' survival.…”

Section: Limitationsmentioning

confidence: 99%

“…Although technologies such as neuronavigation and tractography can assist with surgical planning, the disease's infiltrative nature, combined with the critical functional role of the thalamus, means that resection can risk debilitating outcomes [8,9]. Chemotherapy and radiotherapy are valid adjuvant treatments and can be considered for poor surgical candidates, including those with lesions that cannot be safely removed [1,5,10]. Due to the rarity of thalamic gliomas, most conclusions derive from single-institution case-series and are inadequate to provide sound recommendations.…”

Section: Introductionmentioning

confidence: 99%

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Thalamic gliomas in adults: a systematic review of clinical characteristics, treatment strategies, and survival outcomes

et al. 2021

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Purpose Thalamic gliomas are rare neoplasms that pose significant surgical challenges. The literature is limited to singleinstitution retrospective case series. We systematically review the literature and describe the clinical characteristics, treatment strategies, and survival outcomes of adult thalamic gliomas. Methods Relevant articles were identified on PubMed, Scopus, and Cochrane databases. Papers containing cases of adult thalamic gliomas with clinical outcome data were included. A comprehensive review of clinical characteristics and survival analysis was conducted. ResultsWe included 25 studies comprising 617 patients. The median age was 45 years (male = 58.6%). Glioblastoma was the most frequent histological type (47.2%), and 82 tumors were H3 K27M-mutant. Motor deficit was the most common presenting symptom (51.8%). Surgical resection was performed in 69.1% of cases while adjuvant chemotherapy and radiotherapy were administered in 56.3% and 72.6%, respectively. Other treatments included laser interstitial thermal therapy, which was performed in 15 patients (2.4%). The lesion laterality (P = 0.754) and the surgical approach (P = 0.111) did not correlate with overall survival. The median progression-free survival was 9 months, and the overall two-year survival rate was 19.7%. The two-year survival rates of low-grade and high-grade thalamic gliomas were 31.0% and 16.5%, respectively. H3 K27M-mutant gliomas showed worse overall survival (P = 0.017). Conclusion Adult thalamic gliomas are associated with poor survival. Complete surgical resection is associated with improved survival rates but is not always feasible. H3 K27M mutation is associated with worse survival and a more aggressive approach should be considered for mutant neoplasms.

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