Spinal cord glioblastoma: 25years of experience from a single institution

Yanamadala, Vijay; Koffie, Robert M.; Shankar, Ganesh M.; Kumar, Jay I.; Buchlak, Quinlan D.; Puthenpura, Vidya; Frosch, Matthew P.; Gudewicz, Thomas M; Borges, Lawrence F.; Shin, John H.

doi:10.1016/j.jocn.2015.11.011

Cited by 34 publications

(22 citation statements)

References 25 publications

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“…Some common mutations observed in cranial astrocytomas are also noted in spinal astrocytomas, including mutations in the p16 gene, PTEN, BRAF, p53, and the replicationindependent histone 3 variant H3.3 gene. Specifically, p53 mutations are frequent in spinal cord astrocytomas 9,10 ; however, isocitrate dehydrogenase mutations are seen in low frequencies. 11 The spinal cord is one of the more common locations for astrocytomas mutated by histone H3 on lysine 27 (H3K27) in adults ( Supplementary Fig.…”

Section: Intramedullary Spinal Cord Tumorsmentioning

confidence: 99%

Updates in the management of intradural spinal cord tumors: a radiation oncology focus

et al. 2019

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Primary spinal cord tumors represent a hetereogeneous group of central nervous system malignancies whose management is complex given the relatively uncommon nature of the disease and variety of tumor subtypes, functional neurologic deficits from the tumor, and potential morbidities associated with definitive treatment. Advances in neuroimaging; integration of diagnostic, prognostic, and predictive molecular testing into tumor classification; and developments in neurosurgical techniques have refined the current role of radiotherapy in the multimodal management of patients with primary spinal cord tumors, and corroborated the need for prospective, multidisciplinary discussion and treatment decision making. Radiotherapeutic technological advances have dramatically improved the entire continuum from treatment planning to treatment delivery, and the development of stereotactic radiosurgery and proton radiotherapy provides new radiotherapy options for patients treated in the definitive, adjuvant, or salvage setting. The objective of this comprehensive review is to provide a contemporary overview of the management of primary intradural spinal cord tumors, with a focus on radiotherapy.

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Section: Intramedullary Spinal Cord Tumorsmentioning

confidence: 99%

Updates in the management of intradural spinal cord tumors: a radiation oncology focus

et al. 2019

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“…Five of six patients with grade IV astrocytoma died within 23 months from surgery, while 17 of 19 patients with low-grade lesions (grade I or II) had a mean survival of 50.2 months [26]. In an institutional review of six patients with spinal cord GBM, the functional status exhibited uniform deterioration over one year [27].…”

Section: Reviewmentioning

confidence: 99%

Primary Spinal Astrocytomas: A Literature Review

Ogunlade¹,

Wiginton²,

Elia³

et al. 2019

Cureus

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Primary spinal astrocytoma is a subtype of glioma, the most common spinal cord tumor found in the intradural intramedullary compartment. Spinal astrocytomas account for 6-8% of all spinal cord tumors and are primarily low grade (World Health Organization grade I (WHO I) or WHO II). They are seen in both the adult and pediatric population with the most common presenting symptoms being back pain, sensory dysfunction, or motor dysfunction. Magnetic Resonance Imaging (MRI) with and without gadolinium is the imaging of choice, which usually reveals a hypointense T1 weighted and hyperintense T2 weighted lesion with a heterogeneous pattern of contrast enhancement. Further imaging which may aid in surgical planning includes computerized tomography, diffusion tensor imaging, and tractography. Median survival in spinal cord astrocytomas ranges widely. The factors most significantly associated with poor prognosis and shorter median survival are older age at initial diagnosis, higher grade lesion based on histology, and extent of resection. The mainstay of treatment for primary spinal cord astrocytomas is surgical resection, with the goal of preservation of neurologic function, guided by intraoperative neuromonitoring. Adjunctive radiation has been shown beneficial and may increase overall survival. The role of adjunctive chemotherapy is employed, however, its benefit has not been clearly defined. Primary spinal cord astrocytomas are rare and challenging to treat. The gold standard treatment is surgical resection. Second-line treatments include radiation and chemotherapy, although, the optimal regimen for adjunctive therapy has not yet been clearly defined.

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“…Primary intramedullary spinal cord astrocytomas present rare case entities and account for 30-40% of all spinal cord gliomas [1][2][3]. Despite technical advances, the outcome of infiltrating astrocytomas remains poor [4][5][6], and patients suffer from rapid neurological deterioration [3,5,7]. The gold standard treatment remains a matter of debate as the extent of resection (EOR) does not necessarily correlate with tumor recurrence and may lead to clinical worsening of the patient [4,5,8].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment and neurological outcome of infiltrating intramedullary astrocytoma WHO II–IV: a multicenter retrospective case series

et al. 2020

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Introduction Primary malignant spinal astrocytomas present rare oncological entities with limited median survival and rapid neurological deterioration. Evidence on surgical therapy, adjuvant treatment, and neurological outcome is sparse. We aim to describe the treatment algorithm and clinical features on patients with infiltrating intramedullary astrocytomas graded WHO II–IV. Methods The following is a multicentered retrospective study of patients treated for spinal malignant glioma WHO II–IV in five high-volume neurosurgical departments from 2008 to 2019. Pilocytic astrocytomas were excluded. We assessed data on surgical technique, perioperative neurological status, adjuvant oncological therapy, and clinical outcome. Results 40 patients were included (diffuse astrocytoma WHO II n = 11, anaplastic astrocytoma WHO III n = 12, WHO IV n = 17). Only 40% were functionally independent before surgery, most patients presented with moderate disability (47.5%). Most patients underwent a biopsy (n = 18, 45%) or subtotal tumor resection (n = 15, 37.5%), and 49% of the patients deteriorated after surgery. Patients with WHO III and IV tumors were treated with combined radiochemotherapy. Median overall survival (OS) was 46.5 months in WHO II, 25.7 months in WHO III, and 7.4 months in WHO IV astrocytomas. Preoperative clinical status and WHO significantly influenced the OS, and the extent of resection did not. Conclusion Infiltrating intramedullary astrocytomas WHO II–IV present rare entities with dismal prognosis. Due to the high incidence of surgery-related neurological impairment, the aim of the surgical approach should be limited to obtaining the histological tissue via a biopsy or, tumor debulking in cases with rapidly progressive severe preoperative deficits.

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Spinal cord glioblastoma: 25years of experience from a single institution

Cited by 34 publications

References 25 publications

Updates in the management of intradural spinal cord tumors: a radiation oncology focus

Updates in the management of intradural spinal cord tumors: a radiation oncology focus

Primary Spinal Astrocytomas: A Literature Review

Surgical treatment and neurological outcome of infiltrating intramedullary astrocytoma WHO II–IV: a multicenter retrospective case series

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