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
{"title":"胶质肉瘤：关于临床结果和预后因素的多机构分析","authors":"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","doi":"10.1002/cam4.70347","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>This study describes oncological outcomes and investigates prognostic factors for patients with gliosarcomas (GSM).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Histopathologically confirmed GSM patients who underwent treatment at five European institutions were retrospectively analyzed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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, <i>p</i> < 0.001), subtotal resection (STR) versus biopsy only (HR: 0.15, <i>p</i> = 0.018), gross total resection (GTR) versus biopsy only (HR: 0.13, <i>p</i> = 0.011), pRT versus no pRT (HR: 0.20, <i>p</i> < 0.001), postoperative TMZ-based chemotherapy versus no postoperative chemotherapy (HR: 0.44, <i>p</i> = 0.003), <i>MGMT</i> promoter non-methylated versus methylated (HR: 1.79, <i>p</i> = 0.05), and tumor diameter per cm (HR: 1.15, <i>p</i> = 0.046). For PFS, the following factors were significantly associated in the MVA: GTR versus biopsy only (HR: 0.19, <i>p</i> = 0.026), pRT versus no pRT (HR: 0.36, <i>p</i> = 0.006), postoperative TMZ-based chemotherapy vs. no postoperative chemotherapy (HR: 0.39, <i>p</i> < 0.001), <i>MGMT</i> promoter status unknown versus methylated (HR: 1.69, <i>p</i> = 0.034), and tumor diameter per cm (HR: 1.18, <i>p</i> = 0.016). Sex, primary or secondary GSM, and <i>TP53</i> mutational status were not significantly associated with OS or PFS.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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 <i>MGMT</i> promoters are associated with improved survival. To our knowledge, this is the largest multi-institutional cohort study investigating outcomes and prognostic factors for GSM.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 22","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70347","citationCount":"0","resultStr":"{\"title\":\"Gliosarcoma: A Multi-Institutional Analysis on Clinical Outcomes and Prognostic Factors\",\"authors\":\"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\",\"doi\":\"10.1002/cam4.70347\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>This study describes oncological outcomes and investigates prognostic factors for patients with gliosarcomas (GSM).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Histopathologically confirmed GSM patients who underwent treatment at five European institutions were retrospectively analyzed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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, <i>p</i> < 0.001), subtotal resection (STR) versus biopsy only (HR: 0.15, <i>p</i> = 0.018), gross total resection (GTR) versus biopsy only (HR: 0.13, <i>p</i> = 0.011), pRT versus no pRT (HR: 0.20, <i>p</i> < 0.001), postoperative TMZ-based chemotherapy versus no postoperative chemotherapy (HR: 0.44, <i>p</i> = 0.003), <i>MGMT</i> promoter non-methylated versus methylated (HR: 1.79, <i>p</i> = 0.05), and tumor diameter per cm (HR: 1.15, <i>p</i> = 0.046). For PFS, the following factors were significantly associated in the MVA: GTR versus biopsy only (HR: 0.19, <i>p</i> = 0.026), pRT versus no pRT (HR: 0.36, <i>p</i> = 0.006), postoperative TMZ-based chemotherapy vs. no postoperative chemotherapy (HR: 0.39, <i>p</i> < 0.001), <i>MGMT</i> promoter status unknown versus methylated (HR: 1.69, <i>p</i> = 0.034), and tumor diameter per cm (HR: 1.18, <i>p</i> = 0.016). Sex, primary or secondary GSM, and <i>TP53</i> mutational status were not significantly associated with OS or PFS.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>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 <i>MGMT</i> promoters are associated with improved survival. To our knowledge, this is the largest multi-institutional cohort study investigating outcomes and prognostic factors for GSM.</p>\\n </section>\\n </div>\",\"PeriodicalId\":139,\"journal\":{\"name\":\"Cancer Medicine\",\"volume\":\"13 22\",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70347\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/cam4.70347\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cam4.70347","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Gliosarcoma: A Multi-Institutional Analysis on Clinical Outcomes and Prognostic Factors
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.
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.
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