Epidemiological and clinical characteristics of primary spinal cord glioblastomas: A systematic review and meta-analysis

Introduction

Primary spinal cord glioblastomas (GBMs) are rare neoplasms with distinct clinical and epidemiological characteristics compared to other spinal cord tumors and cranial GBMs. Despite their rarity, their aggressive nature and challenging prognosis make them clinically significant. This study aims to elucidate the clinical and epidemiological characteristics of primary spinal cord GBMs and compare them with cranial GBMs and other spinal cord tumors.

Methodology

The inclusion criteria included case reports or series of primary spinal cord GBMs, while excluding inconclusive histopathological cases and articles not in English or Portuguese. A systematic review and meta-analysis were conducted using PubMed and Mendeley search engines.

Results

The data from 237 patients (mean age: 28.6 years; male-to-female ratio 1.35:1) were analyzed. On radiological imaging, GBMs exhibited patterns similar to those of cranial GBMs. Most tumors were located in the cervical and thoracic regions, with motor deficits as the primary presenting symptom. Almost all patients underwent surgical treatment (88,6%), often followed by adjuvant therapy with chemotherapy (56.5 %) and radiotherapy (68 %). The median progression-free survival (PFS) was 11.5 months, while overall survival (OS) was 15.3 months, with no significant sex or age differences observed.

Conclusion

Primary spinal cord GBMs are rare but aggressive tumors, predominantly affecting young males. Despite similarities with cranial GBMs, differences in incidence, age distribution and aggressiveness exist.