Gliosarcoma: A Multi-Institutional Analysis on Clinical Outcomes and Prognostic Factors

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2024-11-15 DOI:10.1002/cam4.70347

Siyer Roohani, Maximilian Mirwald, Felix Ehret, Christoph Fink, Laila König, Jana Käthe Striefler, Noelle Samira Jacob, Ilinca Popp, Johannes Steffel, Jolina Handtke, Noa Marie Claßen, Titus Rotermund, Daniel Zips, Peter Vajkoczy, Ulrich Schüller, Mateusz Jacek Spałek, David Kaul

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Abstract

Purpose

This study describes oncological outcomes and investigates prognostic factors for patients with gliosarcomas (GSM).

Methods

Histopathologically confirmed GSM patients who underwent treatment at five European institutions were retrospectively analyzed.

Results

We analyzed 170 patients with a median clinical follow-up time of 9.2 months. The majority received surgery (94.1%), postoperative radiotherapy (pRT, 81.8%), and temozolomide (TMZ)-based postoperative chemotherapy (66.5%). The median overall survival (OS) and progression-free survival (PFS) were 12.3 and 6.6 months, respectively. In the multivariable Cox regression analysis (MVA), the following factors were significantly associated with OS: age per year (hazard ratio (HR): 1.03, p < 0.001), subtotal resection (STR) versus biopsy only (HR: 0.15, p = 0.018), gross total resection (GTR) versus biopsy only (HR: 0.13, p = 0.011), pRT versus no pRT (HR: 0.20, p < 0.001), postoperative TMZ-based chemotherapy versus no postoperative chemotherapy (HR: 0.44, p = 0.003), MGMT promoter non-methylated versus methylated (HR: 1.79, p = 0.05), and tumor diameter per cm (HR: 1.15, p = 0.046). For PFS, the following factors were significantly associated in the MVA: GTR versus biopsy only (HR: 0.19, p = 0.026), pRT versus no pRT (HR: 0.36, p = 0.006), postoperative TMZ-based chemotherapy vs. no postoperative chemotherapy (HR: 0.39, p < 0.001), MGMT promoter status unknown versus methylated (HR: 1.69, p = 0.034), and tumor diameter per cm (HR: 1.18, p = 0.016). Sex, primary or secondary GSM, and TP53 mutational status were not significantly associated with OS or PFS.

Conclusions

Trimodal therapy comprising surgical resection, pRT and TMZ-based chemotherapy appears to have the most beneficial effect on survival in GSM patients. Smaller tumor size, younger age and methylated MGMT promoters are associated with improved survival. To our knowledge, this is the largest multi-institutional cohort study investigating outcomes and prognostic factors for GSM.

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胶质肉瘤：关于临床结果和预后因素的多机构分析

目的：本研究描述了胶质肉瘤（GSM）患者的肿瘤学结果，并调查了预后因素。方法：对在欧洲五家医疗机构接受治疗的组织病理学确诊 GSM 患者进行了回顾性分析：我们分析了 170 例患者，中位临床随访时间为 9.2 个月。大多数患者接受了手术（94.1%）、术后放疗（81.8%）和基于替莫唑胺（TMZ）的术后化疗（66.5%）。中位总生存期（OS）和无进展生存期（PFS）分别为12.3个月和6.6个月。在多变量考克斯回归分析（MVA）中，以下因素与OS显著相关：年龄（危险比（HR）：1.03，P 结论：中位生存期（OS）和进展生存期（PFS）分别为12.3个月和6.6个月：由手术切除、pRT和以TMZ为基础的化疗组成的三联疗法似乎对GSM患者的生存有最大的益处。肿瘤体积较小、年龄较轻和甲基化的 MGMT 启动子与生存率的提高有关。据我们所知，这是一项规模最大的多机构队列研究，调查了GSM的预后和预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.