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Hong B, Lalk M, Wiese B, Merten R, Heissler HE, Raab P, Hartmann C, Krauss JK. Primary and secondary gliosarcoma: differences in treatment and outcome. Br J Neurosurg 2024; 38:332-339. [PMID: 33538191 DOI: 10.1080/02688697.2021.1872773] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/24/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION There are only few studies comparing differences in the outcome of primary versus secondary gliosarcoma. This study aimed to review the outcome and survival of patients with primary or secondary gliosarcoma following surgical resection and adjuvant treatment. The data were also matched with data of patients with primary and secondary glioblastoma (GBM). PATIENTS AND METHODS Treatment histories of 10 patients with primary gliosarcoma and 10 patients with secondary gliosarcoma were analysed and compared. Additionally, data of 20 patients with primary and 20 patients with secondary GBM were analysed and compared. All patients underwent surgical resection of the tumour in our department. Follow-up data, progression-free survival (PFS), and median overall survival (mOS) were evaluated. RESULTS The median PFS in patients with primary gliosarcoma was significantly higher than in patients with secondary gliosarcoma (p = 0.037). The 6-month PFS rates were 80.0% in patients with primary and 30.0% in patients with secondary gliosarcoma. Upon recurrence, five patients with primary gliosarcoma and four patients with secondary gliosarcoma underwent repeat surgical resection. The mOS of patients with primary gliosarcoma was significantly higher than that of patients with secondary gliosarcoma (p = 0.031). The percentage of patients surviving at 1-year/2-year follow-up in primary gliosarcoma was 70%/20%, while it was only 10%/10% in secondary gliosarcoma. When PFS and mOS of primary gliosarcoma was compared to primary GBM, there were no statistically differences (p = 0.509; p = 0.435). The PFS and mOS of secondary gliosarcoma and secondary GBM were also comparable (p = 0.290 and p = 0.390). CONCLUSION Patients with primary gliosarcoma have a higher PFS and mOS compared to those with secondary gliosarcoma. In the case of tumour recurrence, patients with secondary gliosarcoma harbour an unfavourable prognosis with limited further options. The outcome of patients with primary or secondary gliosarcoma is comparable to that of patients with primary or secondary GBM.
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Affiliation(s)
- Bujung Hong
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
- Department of Neurosurgery, Brandenburg Medical School, Helios Medical Center, Bad Saarow, Germany
| | - Michael Lalk
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Bettina Wiese
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Roland Merten
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
| | - Hans E Heissler
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Peter Raab
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Christian Hartmann
- Department for Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
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Gandhi P, Khare R, Garg N, Mishra J. Can a signature molecular-profile define disparate survival in BRAF-positive Gliosarcoma and identify novel targets for therapeutic intervention? J Cancer Res Ther 2022; 18:224-230. [DOI: 10.4103/jcrt.jcrt_1900_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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de Macedo Filho LJM, Barreto EG, Martins PLB, Filho ENS, Gerson G, de Albuquerque LAF. IDH1-mutant primary intraventricular gliosarcoma: Case report and systematic review of a rare location and molecular profile. Surg Neurol Int 2020; 11:372. [PMID: 33408906 PMCID: PMC7771479 DOI: 10.25259/sni_586_2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/07/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Gliosarcoma (GS) is classified as an IDH-wild-type variant of glioblastoma (GBM). While GS is already an unusual presentation of GBM, IDH1-mutant cases are especially rare. We present an IDH1-mutant primary intraventricular GS case report and a systematic review of the molecular profile in GS correlating to the prognostic and pathogenesis of IDH1/2 mutations. Case Description: A 44-years-old man presented with ongoing fatigue symptoms and a new-onset intense occipital headache. The patient complained of memory loss, dyscalculia, and concentration difficulties. An MRI revealed a bihemispheric intraventricular mass crossing the midline through the corpus callosum and infiltrating the trigone of the lateral ventricles, hypointense, and hyperintense on the T1- and T2-weighted image. We performed a microsurgical resection with a transparietal transsulcal approach; however, the contralateral mass was attached to vascular structures and we decided to reoperate the patient in another moment. The histopathological study showed a Grade IV tumor and the immunohistochemistry confirmed the diagnosis of GS. The patient presented progressive neurologic decline and died 45 days after the surgical approach. Conclusion: We did two systematic reviews studies from PubMed, EMBASE, MEDLINE, Cochrane, and SCOPUS databases, and included molecular and intraventricular studies of GS. We performed further meta-analysis using OpenMetaAnalyst™ software. We conducted a forest plot with the molecular profile of GS. When correlated IDH1 mutation versus tp53 mutation, we found an odds ratio (OR) of 0.018 (0.005–0.064) and P < 0.001. Moreover, we compared IDH1 mutation versus MGMT methylation (P = 0.006; OR = 0.138 [0.034–0.562]). The studies evaluating the molecular profile in GS prognostics are often extended from all GBMs despite specifics GBM variants (i.e., GS). We found a correlation between IDH1 mutation expression with tp53 and MGMT expression in GS, and future studies exploring this molecular profile in GS are strongly encouraged.
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Affiliation(s)
| | | | | | | | - Gunter Gerson
- Department of Neurosurgery, General Hospital of Fortaleza, Fortaleza, Ceara, Brazil
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de Almeida RMS, Fontana LC, Dos Santos Vitorio G, Pereira AHC, Soares CP, Pinto JG, Ferreira-Strixino J. Analysis of the effect of photodynamic therapy with Fotoenticine on gliosarcoma cells. Photodiagnosis Photodyn Ther 2020; 30:101685. [PMID: 32050104 DOI: 10.1016/j.pdpdt.2020.101685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/23/2020] [Accepted: 02/07/2020] [Indexed: 01/03/2023]
Abstract
Gliosarcoma is a highly aggressive malignant neoplasm and a histopathological variant of wild-type glioblastoma multiforme isocitrate dehydrogenase (HDI). The current standard treatment consists of chemotherapy, radiotherapy and surgical resection, however, despite advances in these techniques, the patient's prognosis remains unfavorable. Photodynamic therapy (PDT) is a noninvasive technique that has been highlighted as an alternative form of cancer treatment because it does not present the side effects associated with systemic treatments. The objective of this study was to evaluate the cell viability and the intracellular localization of photosensitizer (PS) chlorin e6 Fotoenticine in 9L/lacZ cells. Therefore, tests of cytotoxicity, morphology, and location of PS were performed. The viability test showed no cytotoxicity in the dark at all concentrations and 100 % cell death at the highest concentrations after PDT. The mitochondrial activity test showed a reduction in all groups after PDT. The production of reactive oxygen species (ROS) was higher in the PDT groups and dependent on the PS concentration. Morphological analysis after PDT showed apparent cytoplasmic destruction in all the tested concentrations, with the presence of rounded cells due to the loss of their extensions and absence of nuclear alterations. The PS accumulation in the mitochondria and cytoskeleton was observed by the confocal microscopy; however, there is no evidence of its internalization in the lysosomes. It was concluded that PDT with Fotoenticine is a promising alternative therapy showing decreased cell viability, increased ROS production and adequate localization to trigger cell death.
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Affiliation(s)
- Rainara Moreno Sanches de Almeida
- Laboratory of Photobiology Applied to Health, Institute of Research and Development, University of Vale do Paraíba, Av. Shishima Hifumi, 2911, Urbanova, CEP: 12244-000, São José dos Campos, SP, Brazil
| | - Letícia Corrêa Fontana
- Laboratory of Photobiology Applied to Health, Institute of Research and Development, University of Vale do Paraíba, Av. Shishima Hifumi, 2911, Urbanova, CEP: 12244-000, São José dos Campos, SP, Brazil
| | - Gabrielle Dos Santos Vitorio
- Laboratory of Photobiology Applied to Health, Institute of Research and Development, University of Vale do Paraíba, Av. Shishima Hifumi, 2911, Urbanova, CEP: 12244-000, São José dos Campos, SP, Brazil
| | - André Henrique Correia Pereira
- Laboratory of Photobiology Applied to Health, Institute of Research and Development, University of Vale do Paraíba, Av. Shishima Hifumi, 2911, Urbanova, CEP: 12244-000, São José dos Campos, SP, Brazil
| | - Cristina Pacheco Soares
- Laboratory of Cell Compartment Dynamics, Institute of Research and Development, University of Vale do Paraíba, Av. Shishima Hifumi, 2911, Urbanova, CEP: 12244-000, São José dos Campos, SP, Brazil
| | - Juliana Guerra Pinto
- Laboratory of Photobiology Applied to Health, Institute of Research and Development, University of Vale do Paraíba, Av. Shishima Hifumi, 2911, Urbanova, CEP: 12244-000, São José dos Campos, SP, Brazil
| | - Juliana Ferreira-Strixino
- Laboratory of Photobiology Applied to Health, Institute of Research and Development, University of Vale do Paraíba, Av. Shishima Hifumi, 2911, Urbanova, CEP: 12244-000, São José dos Campos, SP, Brazil.
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Langlois AM, Alarfaj AK, Sagga A, Findlay JM, Das S. Gliosarcoma in a Young Filipino Woman: A Case Report and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:914-919. [PMID: 31243260 PMCID: PMC6613492 DOI: 10.12659/ajcr.916020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Patient: Female, 28 Final Diagnosis: Gliosarcoma Symptoms: Foot drop Medication: — Clinical Procedure: — Specialty: Neurosurgery
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Affiliation(s)
- Anne-Marie Langlois
- Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Abdullah K Alarfaj
- Division of Neurosurgery, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, Alberta, Canada
| | - Aziz Sagga
- Division of Neurosurgery, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, Alberta, Canada
| | - J Max Findlay
- Division of Neurosurgery, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, Alberta, Canada
| | - Sumit Das
- Division of Neuropathology, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, Alberta, Canada.,Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
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