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De S, Paul S, Manna A, Majumder C, Pal K, Casarcia N, Mondal A, Banerjee S, Nelson VK, Ghosh S, Hazra J, Bhattacharjee A, Mandal SC, Pal M, Bishayee A. Phenolic Phytochemicals for Prevention and Treatment of Colorectal Cancer: A Critical Evaluation of In Vivo Studies. Cancers (Basel) 2023; 15:cancers15030993. [PMID: 36765950 PMCID: PMC9913554 DOI: 10.3390/cancers15030993] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/08/2023] Open
Abstract
Colorectal cancer (CRC) is the third most diagnosed and second leading cause of cancer-related death worldwide. Limitations with existing treatment regimens have demanded the search for better treatment options. Different phytochemicals with promising anti-CRC activities have been reported, with the molecular mechanism of actions still emerging. This review aims to summarize recent progress on the study of natural phenolic compounds in ameliorating CRC using in vivo models. This review followed the guidelines of the Preferred Reporting Items for Systematic Reporting and Meta-Analysis. Information on the relevant topic was gathered by searching the PubMed, Scopus, ScienceDirect, and Web of Science databases using keywords, such as "colorectal cancer" AND "phenolic compounds", "colorectal cancer" AND "polyphenol", "colorectal cancer" AND "phenolic acids", "colorectal cancer" AND "flavonoids", "colorectal cancer" AND "stilbene", and "colorectal cancer" AND "lignan" from the reputed peer-reviewed journals published over the last 20 years. Publications that incorporated in vivo experimental designs and produced statistically significant results were considered for this review. Many of these polyphenols demonstrate anti-CRC activities by inhibiting key cellular factors. This inhibition has been demonstrated by antiapoptotic effects, antiproliferative effects, or by upregulating factors responsible for cell cycle arrest or cell death in various in vivo CRC models. Numerous studies from independent laboratories have highlighted different plant phenolic compounds for their anti-CRC activities. While promising anti-CRC activity in many of these agents has created interest in this area, in-depth mechanistic and well-designed clinical studies are needed to support the therapeutic use of these compounds for the prevention and treatment of CRC.
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Affiliation(s)
- Samhita De
- Division of Molecular Medicine, Bose Institute, Kolkata 700 054, India
| | - Sourav Paul
- Department of Biotechnology, National Institute of Technology, Durgapur 713 209, India
| | - Anirban Manna
- Division of Molecular Medicine, Bose Institute, Kolkata 700 054, India
| | | | - Koustav Pal
- Jawaharlal Institute Post Graduate Medical Education and Research, Puducherry 605 006, India
| | - Nicolette Casarcia
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA
| | - Arijit Mondal
- Department of Pharmaceutical Chemistry, M.R. College of Pharmaceutical Sciences and Research, Balisha 743 234, India
| | - Sabyasachi Banerjee
- Department of Pharmaceutical Chemistry, Gupta College of Technological Sciences, Asansol 713 301, India
| | - Vinod Kumar Nelson
- Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, Anantapur 515 721, India
| | - Suvranil Ghosh
- Division of Molecular Medicine, Bose Institute, Kolkata 700 054, India
| | - Joyita Hazra
- Department of Biotechnology, Indian Institute of Technology, Chennai 600 036, India
| | - Ashish Bhattacharjee
- Department of Biotechnology, National Institute of Technology, Durgapur 713 209, India
| | | | - Mahadeb Pal
- Division of Molecular Medicine, Bose Institute, Kolkata 700 054, India
- Correspondence: or (M.P.); or (A.B.)
| | - Anupam Bishayee
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA
- Correspondence: or (M.P.); or (A.B.)
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Schwartz KA, Noel M, Nikolai M, Olson LK, Hord NG, Zakem M, Clark J, Elnabtity M, Figueroa B, Chang HT. Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet. Front Nutr 2022; 9:770796. [PMID: 35592625 PMCID: PMC9112915 DOI: 10.3389/fnut.2022.770796] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 02/23/2022] [Indexed: 12/11/2022] Open
Abstract
Aggressive primary brain tumors (APBT) glioblastoma multiforme and grade IV astrocytoma are treated with multimodality treatments that include surgery to remove as much tumor as possible without sacrificing neurological function followed by radiation therapy and chemotherapy usually temozolomide. Survivals in adults are in the range of 8–16 months. The addition of a ketogenic diet (KD) to rodents with transplanted brain tumors increased survival in nine of 11 animals to over 299 days compared to survival in untreated controls of 33 days and radiation only controls of 38 days. We treated humans with APBT with standard of care neurosurgery immediately followed by 6 weeks of an adjuvant ketogenic diet concurrent with radiation therapy and temozolomide. Twice daily measurements of blood ketones and glucose were recorded and the patients' diet was modified toward the goal of maintaining blood ketone levels approaching 3 mM. Of the nine patients who completed the protocol three younger patients age 32, 28, and 22 at enrollment are alive and employed with clinically stable disease and brain images 74, 58, and 52 months since diagnosis. All the six older patients mean age 55 have died with disease progression detected on average 8 months after Dx. In conclusion: 1. It is possible to implement and maintain dietary induced ketosis in patients with APBT; 2. The longer survivals observed in younger patients treated with KD need to be confirmed in larger studies that should be focused on younger patients possibly under age 40.
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Affiliation(s)
- Kenneth A. Schwartz
- Colleges of Human and Osteopathic Medicine, Michigan State University, East Lansing, MI, United States
- Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, United States
- *Correspondence: Kenneth A. Schwartz
| | - Mary Noel
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI, United States
- Department of Family Practice, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Michele Nikolai
- Department of Food Science and Human Nutrition, College of Agriculture and Natural Resources, Michigan State University, East Lansing, MI, United States
| | - Lawrence K. Olson
- Department of Physiology, College of Natural Sciences, Michigan State University, East Lansing, MI, United States
| | - Norman G. Hord
- Department of Nutritional Sciences, Harold Hamm Diabetes Center, College of Allied Health, University of Oklahoma, Oklahoma City, OK, United States
| | - Micheal Zakem
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI, United States
| | - Justin Clark
- College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Mohamed Elnabtity
- College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Bryan Figueroa
- College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Howard T. Chang
- Colleges of Human and Osteopathic Medicine, Michigan State University, East Lansing, MI, United States
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Marton E, Giordan E, Siddi F, Curzi C, Canova G, Scarpa B, Guerriero A, Rossi S, D' Avella D, Longatti P, Feletti A. Over ten years overall survival in glioblastoma: A different disease? J Neurol Sci 2019; 408:116518. [PMID: 31715330 DOI: 10.1016/j.jns.2019.116518] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 09/11/2019] [Accepted: 10/02/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The reasons why a specific subset of glioblastoma (GBM) patients survive longer than others is still unclear. This study analyzed a cohort of long-term and very-long-term GBM survivors to determine which genetic alterations or patient's characteristics influence survival time. METHODS We retrospectively reviewed a cohort of GBM patients treated at our institution over the last 20 years, stratifying patients in three groups: those with a survival time ≥ 36 months and < 120 months (LTS), ≥120 months (VLTS), and < 36 months, respectively. Clinical (age, sex, focality, resection degree, Karnofsky performance status), and immunohistochemical and molecular data (Ki-67 expression and multiple genes alterations) were collected. We then utilized principal component analysis, logistic regression, and Cox proportional hazard models to identify those variables associated with survival. RESULTS Younger age at presentation (HR = 0.36, 95% CI 0.21-0.67, p = .001), and MGMT promoter [(MGMTp), methylated, HR = 0.57, CI 0.34-0.96, p = .034) were associated with higher odds of VLTS survival. The multivariate analysis showed how the combination of younger age (< 50 years), Ki-67 < 10%, and the coexistence of TERTp not mutated, MGMTp methylated, and IDH1/2 mutated in the same patient are also associated with higher odds of survival (HR = 0.10, CI 0.01-0.74, p = .025). CONCLUSIONS We confirmed younger age at presentation and MGMTp methylation as the only independent factors associated with VLTS. The exceptional survival of our VLTS patients is probably associated with different, still understudied, gene mutations, or with the coexistence of multiple factors.
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Affiliation(s)
- Elisabetta Marton
- Department of Neurosurgery, Padova University, Treviso Regional Hospital, Treviso, Italy
| | - Enrico Giordan
- Department of Neurosurgery, Padova University, Treviso Regional Hospital, Treviso, Italy.
| | - Francesca Siddi
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Christian Curzi
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Giuseppe Canova
- Department of Neurosurgery, Padova University, Treviso Regional Hospital, Treviso, Italy
| | - Bruno Scarpa
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | - Angela Guerriero
- Department of Pathology, Treviso Regional Hospital, Treviso, Italy
| | - Sabrina Rossi
- Department of Pathology, Bambin Gesù Children's Hospital, Rome, Italy
| | | | - Pierluigi Longatti
- Department of Neurosurgery, Padova University, Treviso Regional Hospital, Treviso, Italy
| | - Alberto Feletti
- Department of Neurosciences, Biomedicine and Movement Sciences, Neurosurgery Unit, University of Verona, Italy
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Tykocki T, Eltayeb M. Ten-year survival in glioblastoma. A systematic review. J Clin Neurosci 2018; 54:7-13. [PMID: 29801989 DOI: 10.1016/j.jocn.2018.05.002] [Citation(s) in RCA: 185] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 04/09/2018] [Accepted: 05/17/2018] [Indexed: 02/07/2023]
Abstract
Glioblastoma (GBM) is among the most deadly neoplasms associated with one of the worst 5-year overall survival (OS) rates among all human cancers. The aim of this systematic review is to present all cases with OS of a decade or more and to perform a descriptive analysis of the group. This systematic review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. A comprehensive search for relevant articles was performed on PubMed, Embase and Google Scholar for a period until June 10, 2016, using the following search words: glioblastoma multiforme, glioblastoma, GBM, long-term survival/survivors. Reports containing cases with the long-term survival of 10 years or longer were included in the review. The search produced 36 studies with 162 cases published in the years 1950-2014. The rate of long survivors in the cohort studied was established 0.76%. Mean age at diagnosis, OS and PFS were 31.1 ± 11.1, 15.9 ± 6.3, 11.9 ± 5.6 years respectively. Total and subtotal resections were found in 82 and 58 patients respectively. Nine cases received a biopsy alone. No statistical differences were found in a comparison of PFS, OS and age between total and subtotal resection groups. A regression analysis showed a significant correlation between PFS and OS, with an inverse relationship stated between age at diagnosis and OS. The 10-year survival rate in the cohort studied with GBM was estimated 0.71%. OS was positively correlated with the length of PFS and inversely related with age at diagnosis.
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Affiliation(s)
- Tomasz Tykocki
- Department of Neurosurgery, Western Hospital in Grodzisk Mazowiecki, Poland.
| | - Mohamed Eltayeb
- Royal Victoria Infirmary, NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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5
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Amayiri N, Tabori U, Campbell B, Bakry D, Aronson M, Durno C, Rakopoulos P, Malkin D, Qaddoumi I, Musharbash A, Swaidan M, Bouffet E, Hawkins C, Al-Hussaini M. High frequency of mismatch repair deficiency among pediatric high grade gliomas in Jordan. Int J Cancer 2015; 138:380-5. [PMID: 26293621 DOI: 10.1002/ijc.29724] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 07/09/2015] [Indexed: 02/02/2023]
Abstract
Biallelic mismatch repair deficiency (bMMRD) is a cancer predisposition syndrome affecting primarily individuals from consanguinous families resulting in multiple childhood cancers including high grade gliomas (HGG). This is the first study to assess the prevalence of bMMRD among patients with HGG in countries where consanguinity is high. We collected molecular and clinical information on all children diagnosed with HGG and supratentorial primitive neuroectodermal tumors (sPNET) between 2003 and 2013 at King Hussein Cancer Center, Jordan. Comparison was made to a similar cohort from Toronto. Clinical data regarding presence of café au lait macules(CAL), family history of cancer, consanguinity, pathology and treatment were collected. Tumors were centrally reviewed and tested for MMRD by immunohistochemistry of the corresponding proteins. Forty-two patients fulfilled the inclusion criteria, including 36 with HGG. MMRD was observed in 39% of HGG of whom 79% also lost MMR staining in the corresponding normal cells suggestive of bMMRD. P53 dysfunction was highly enriched in MMR deficient tumors (p = 0.0003).The frequency of MMRD was significantly lower in Toronto cohort (23%, p = 0.03). Both evidence of CAL and consanguinity correlated with bMMRD (p = 0.005 and 0.05,respectively) but family history of cancer didn't. HGG with all three bMMRD risk factors had evidence of MMRD and all children affected by multiple bMMRD related cancers had identical gene loss by immunohistochemical staining. In Jordan, the frequency of clinical and immunohistochemical alterations suggestive of bMMRD in pediatric HGG is high. Genetic testing will enable appropriate counseling and cancer screening to improve survival of these patients.
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Affiliation(s)
- Nisreen Amayiri
- Department of Pediatrics Hematology/Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Uri Tabori
- Division of Hematology/Oncology, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada.,Department of Pediatrics, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada.,Arthur and Sonia Labbatt Brain Tumor Research Center, Toronto, Canada
| | - Brittany Campbell
- Division of Hematology/Oncology, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada.,Department of Pediatrics, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada
| | - Doua Bakry
- Division of Hematology/Oncology, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada.,Department of Pediatrics, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada
| | - Melyssa Aronson
- The Familial Gastrointestinal Cancer Registry at the Zane Cohen Centre for Digestive Disease and Department of Surgery, Mount Sinai Hospital, Toronto, Canada
| | - Carol Durno
- The Familial Gastrointestinal Cancer Registry at the Zane Cohen Centre for Digestive Disease and Department of Surgery, Mount Sinai Hospital, Toronto, Canada.,Division of Gastroenterology, Nutrition and Hepatology, The Hospital for Sick Children, Toronto, Canada
| | - Patricia Rakopoulos
- Division of Pathology, Arthur and Sonia Labatt Brain Tumour Research Center, The Hospital for Sick Children, Toronto, Canada
| | - David Malkin
- Division of Hematology/Oncology, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada.,Department of Pediatrics, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada
| | | | - Awni Musharbash
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Maisa Swaidan
- Department of Radiology, King Hussein Cancer Center, Amman, Jordan
| | - Eric Bouffet
- Division of Hematology/Oncology, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada.,Department of Pediatrics, The Hospital for Sick Children, Institute of Medical Sciences, the University of Toronto, Toronto, Canada
| | - Cynthia Hawkins
- Division of Pathology, Arthur and Sonia Labatt Brain Tumour Research Center, The Hospital for Sick Children, Toronto, Canada
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Ma S, Hu Y, Yang J, Zhou X. Turcot's syndrome associated with intestinal non-Hodgkin's lymphoma: case report and review of literature. Clin Neurol Neurosurg 2012; 115:117-20. [PMID: 22676959 DOI: 10.1016/j.clineuro.2012.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 04/12/2012] [Accepted: 04/30/2012] [Indexed: 11/30/2022]
Abstract
A 15-year-old boy was admitted with the diagnosis of colonic polyposis, and during a 2-year follow-up, he underwent operation for right parieto-occipital anaplastic astrocytoma, left-side colonic non-Hodgkin lymphoma (NHL) and cerebella glioblastoma which were all confirmed by histology. Although cases of Turcot's syndrome (TS) (colonic polyposis and primary brain tumour occurring in the same patient) have been previously described, association with haematological malignancy is rare. We hereby report such a case with TS.
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Affiliation(s)
- ShunChang Ma
- Neurosurgery, Fuxing Hospital Affiliated to Capital Medical University, Beijing, China.
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7
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Abstract
Long-term survivors of glioblastoma (GB) are rare. Several variables besides tumor size and location determine a patient's survival chances: age at diagnosis, where younger patients often receive more aggressive treatment that is multimodal; functional status, which has a significant negative correlation with age; and histologic and genetic markers.
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Sjursen W, Bjørnevoll I, Engebretsen LF, Fjelland K, Halvorsen T, Myrvold HE. A homozygote splice site PMS2 mutation as cause of Turcot syndrome gives rise to two different abnormal transcripts. Fam Cancer 2008; 8:179-86. [PMID: 19039682 DOI: 10.1007/s10689-008-9225-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Accepted: 11/10/2008] [Indexed: 01/24/2023]
Abstract
Turcot syndrome is a rare, inherited disease predisposing of tumours in the central nerve system and in the colorectal system. This report describes a Turcot patient with an extraordinary clinical history. The patient is still alive at the age of 43. She was operated at the age of 10 by brain tumour and at the age of 16 by colorectal cancer. She has since then been treated for multiple cancers (gastrointestinal, endometrial, basal cell carcinomas), and removal of adenomatous polyps at several occasions. The aim of this work was to investigate if there was any specific genotype that explains her remarkable clinical history. Microsatellite instability and immunohistochemistry analysis for four DNA mismatch repair proteins were performed. DNA mutation analysis was done for genes involved in polyposis and mismatch repair by denaturing high performance liquid chromatography and sequencing. cDNA analysis was carried out for the mismatch repair gene PMS2. The patients genotype was found to be a homozygous splice site mutation in the PMS2 gene, c.989-1G<T, which resulted in two abnormal transcripts, not one as expected. The patient's long time survival may in part be explained by meticulous follow up by health care professionals. The other importing factor is probably the nature of here genotype. cDNA analysis showed that the homozygous mutation led to two abnormal transcripts, of which one is perhaps less detrimental. Thus cDNA analysis is of prime importance for the full evaluation of the effect of putative splicing mutations.
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Affiliation(s)
- Wenche Sjursen
- Department of Pathology and Medical Genetics, St. Olavs University Hospital, Erling Skjalgssons gt.1, 7006 Trondheim, Norway.
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9
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Gottschling S, Reinhard H, Pagenstecher C, Krüger S, Raedle J, Plotz G, Henn W, Buettner R, Meyer S, Graf N. Hypothesis: Possible role of retinoic acid therapy in patients with biallelic mismatch repair gene defects. Eur J Pediatr 2008; 167:225-9. [PMID: 17387511 DOI: 10.1007/s00431-007-0474-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2007] [Accepted: 03/13/2007] [Indexed: 11/30/2022]
Abstract
A boy showing symptoms of a Turcot-like childhood cancer syndrome together with stigmata of neurofibromatosis type I is reported. His brother suffers from an infantile myofibromatosis, and a sister died of glioblastoma at age 7. Another 7-year-old brother is so far clinically unaffected. The parents are consanguineous. Molecular diagnosis in the index patient revealed a constitutional homozygous mutation of the mismatch repair gene PMS2. The patient was in remission of his glioblastoma (WHO grade IV) after multimodal treatment followed by retinoic acid chemoprevention for 7 years. After discontinuation of retinoic acid medication, he developed a relapse of his brain tumour together with the simultaneous occurrence of three other different HNPCC-related carcinomas. We think that retinoic acid might have provided an effective chemoprevention in this patient with homozygous mismatch repair gene defect. We propose to take a retinoic acid chemoprevention into account in children with proven biallelic PMS2 mismatch repair mutations being at highest risk concerning the development of a malignancy.
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Affiliation(s)
- Sven Gottschling
- Department of Pediatric Hematology and Oncology Saarland University, University Children's Hospital, Homburg, Germany.
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10
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Murphy HR, Taylor W, Ellis A, Sturgess R. An unusual case of Turcot’s syndrome associated with ileal adenocarcinoma, intestinal non-Hodgkin’s lymphoma, and duodenal adenocarcinoma. Review of the classification and genetic basis of Turcot’s syndrome. Fam Cancer 2005; 4:139-43. [PMID: 15951965 DOI: 10.1007/s10689-004-2759-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2004] [Accepted: 08/29/2004] [Indexed: 11/28/2022]
Abstract
A 38-year-old man with a history of colonic and small bowel polyposis and glioblastoma was investigated for dyspepsia. Upper GI endoscopy identified an abnormal area in the duodenum, confirmed by histology as high grade non-Hodgkin's B cell MALT lymphoma. Although cases of Turcot's syndrome (TS) (colonic polyposis and primary brain tumour occurring in the same patient) have been previously described, association with haematological malignancy is rare. This is the first report of intestinal lymphoma occurring in an adult with TS.
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Affiliation(s)
- H R Murphy
- Department of Clinical Genetics, Royal Liverpool Children's Hospital-Alder Hey, Eaton Road, Liverpool, L12 2AP, UK.
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11
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Polin RS, Marko NF, Ammerman MD, Shaffrey ME, Huang W, Anderson FA, Caputy AJ, Laws ER. Functional outcomes and survival in patients with high-grade gliomas in dominant and nondominant hemispheres. J Neurosurg 2005; 102:276-83. [PMID: 15739555 DOI: 10.3171/jns.2005.102.2.0276] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object. The goal of this study was to investigate survival and functional outcomes in patients with high-grade intracranial astrocytomas as a function of the location of the lesion in the dominant or nondominant hemisphere (DH and NDH, respectively), and to suggest management strategies for such patients based on these data.
Methods. Data were collected from the Glioma Outcomes Project database, a longitudinal database of demographic, clinical, and outcome data for patients with high-grade intracranial gliomas. From the entire database of 788 patients, a subset of all 280 right-handed patients with newly diagnosed, unilateral gliomas involving potentially eloquent cortex was selected as the sample population. Two cohorts were defined based on the location of the tumor in the right or left cerebral hemisphere. All other relevant demographic and clinical data were nearly identical between the cohorts. A Kaplan—Meier analysis was conducted to assess survival, and Karnofsky Performance Scale scores assigned at 6 and 12 months postoperatively were compared as a measure of functional outcome.
The analysis demonstrated no difference in survival between patients with lesions in the DH and those with tumors in the NDH. Additionally, no statistically significant difference in functional outcomes was observed between the two groups.
Conclusions. Laterality of high-grade gliomas is not an independent prognostic factor for predicting survival or functional outcome. The findings in this study demonstrate that fears of increased postoperative morbidity or mortality in otherwise resectable tumors of the DH are unfounded, and the authors therefore advocate that the surgeon's decision to operate be guided by validated outcome predictors and not biased by tumor lateralization.
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Affiliation(s)
- Richard S Polin
- Department of Neurosurgery, School of Medicine, The George Washington University, Washington, DC 20037, USA.
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12
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Shinojima N, Kochi M, Hamada JI, Nakamura H, Yano S, Makino K, Tsuiki H, Tada K, Kuratsu JI, Ishimaru Y, Ushio Y. The influence of sex and the presence of giant cells on postoperative long-term survival in adult patients with supratentorial glioblastoma multiforme. J Neurosurg 2004; 101:219-26. [PMID: 15309911 DOI: 10.3171/jns.2004.101.2.0219] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Glioblastoma multiforme (GBM) remains incurable by conventional treatments, although some patients experience long-term survival. A younger age, a higher Karnofsky Performance Scale (KPS) score, more aggressive treatment, and long progression-free intervals have been reported to be positively associated with long-term postoperative patient survival. The aim of this retrospective study was the identification of additional favorable prognostic factors affecting long-term survival in surgically treated adult patients with supratentorial GBM. METHODS Of 113 adult patients newly diagnosed with histologically verified supratentorial GBM who were enrolled in Phase III trials during the period between 1987 and 1998, six (5.3%) who survived for longer than 5 years were defined as long-term survivors, whereas the remaining 107 patients served as controls. All six were women and were compared with the controls; they were younger (mean age 44.2 years, range 31-60 years), and their preoperative KPS scores were higher (mean 85, range 60-100). Four of the six patients underwent gross-total resection. In five patients (83.3%) the progression-free interval was longer than 5 years and in three a histopathological diagnosis of giant cell GBM was made. This diagnosis was not made in the other 107 patients. CONCLUSIONS Among adult patients with supratentorial GBM, female sex and histopathological characteristics consistent with giant cell GBM may be predictive of a better survival rate, as may traditional factors (that is, younger age, good KPS score, more aggressive resection, and a long progression-free interval).
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Affiliation(s)
- Naoki Shinojima
- Department of Neurosurgery, Kumamoto University School of Medicine, Kumamoto, Japan.
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13
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Okamoto H, Mineta T, Nakahara Y, Ichinose M, Shiraishi T, Tabuchi K. Molecular analysis of astrocytoma associated with Turcot syndrome type 1--case report. Neurol Med Chir (Tokyo) 2004; 44:124-8. [PMID: 15095965 DOI: 10.2176/nmc.44.124] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 49-year-old man presented with a brain tumor and colon carcinoma. The patient had been treated under diagnoses of hereditary non-polyposis colorectal cancer syndrome and Muir-Torre syndrome. Magnetic resonance imaging revealed a mass lesion in the right frontal lobe with diffuse high intensity on T2-weighted and fluid-attenuated inversion recovery images. A few small lesions were enhanced by gadolinium on the T1-weighted images. Histological examination revealed the brain neoplasm was astrocytoma grade III according to the World Health Organization classification. Molecular genetic analysis detected microsatellite instability and p53 mutation only in the tumor tissue, indicating a failure of the deoxyribonucleic acid mismatch repair system. These results suggest that inactivation of mismatch repair system and p53 is closely associated with the tumorigenesis of this neoplasm. The final diagnosis was Turcot syndrome type 1.
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Affiliation(s)
- Hiroaki Okamoto
- Department of Neurosurgery, Saga Medical School, Saga, Japan.
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Sabel M, Reifenberger J, Weber RG, Reifenberger G, Schmitt HP. Long-term survival of a patient with giant cell glioblastoma. Case report. J Neurosurg 2001; 94:605-11. [PMID: 11302659 DOI: 10.3171/jns.2001.94.4.0605] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors report on a patient who had undergone resection of a left-sided temporal giant cell glioblastoma at the age of 69 years and who survived for more than 17 years. This man had not undergone postoperative radiotherapy or adjuvant chemotherapy. He died at the age of 86 years without clinical evidence of tumor recurrence. Histologically, the lesion was characterized by highly pleomorphic tumor cells (including bizarre multinucleated giant cells) with high mitotic activity, large necroses, and prominent mononuclear infiltration. A point mutation in the TP53 tumor suppressor gene (c.524G>A; R175H) and no epidermal growth factor receptor gene amplification were revealed on molecular genetic analysis. No diagnostic chromosomal imbalances were identified on comparative genomic hybridization, although the average ratio profile for chromosome 10 indicated loss of 10p15 in a subpopulation of tumor cells. This patient is exceptional because tumor resection, probably in conjunction with a marked antitumor immune response, apparently resulted in eradication of the lesion.
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Affiliation(s)
- M Sabel
- Department of Neurosurgery, Heinrich-Heine-University, Düsseldorf, Germany.
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15
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Yoshida T, Kawano N, Oka H, Fujii K, Nakazato Y. Clinical cure of glioblastoma--two case reports. Neurol Med Chir (Tokyo) 2000; 40:224-9. [PMID: 10853323 DOI: 10.2176/nmc.40.224] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report two cases of "decade survivor" of glioblastoma. Case 1 is a 34-year-old female who developed a tumor in the left frontal pole, and Case 2 is a 46-year-old male with a left frontal tumor. Both tumors were surgically excised and the patients received postoperative chemo-radiotherapy. Histological re-evaluation of the resected tumor tissue confirmed the most malignant type of glioma-glioblastoma. We speculate that the entire extent of tumors had been extirpated by surgery in both cases.
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Affiliation(s)
- T Yoshida
- Department of Neurosurgery, Kitasato University School of Medicine
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16
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Taylor MD, Perry J, Zlatescu MC, Stemmer-Rachamimov AO, Ang LC, Ino Y, Schwartz M, Becker LE, Louis DN, Cairncross JG. The hPMS2 exon 5 mutation and malignant glioma. Case report. J Neurosurg 1999; 90:946-50. [PMID: 10223463 DOI: 10.3171/jns.1999.90.5.0946] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Patients with Turcot syndrome (TS) are predisposed to colon tumors and primary brain tumors, typically glioblastomas or medulloblastomas. The authors describe a patient with TS featuring a known germline mutation of exon 5 of the hPMS2 mismatch repair gene who developed two metachronous glioblastomas, both with distinct oligodendroglial features. Molecular genetic analysis revealed allelic loss of chromosome 19q in the patient's second tumor but no allelic loss of chromosome 1p. Prominent microsatellite instability was also found in this tumor, consistent with a germline mismatch repair defect. Because this patient had an unusual underlying condition and his tumor had a unique histological appearance for TS, it was hypothesized that this genetic defect may predispose to malignant gliomas with oligodendroglial features. The authors therefore evaluated whether sporadic glioblastomas and oligodendrogliomas undergo mutations of this region of the hPMS2 gene. However, single-strand conformation polymorphism analysis of hPMS2 exon 5 failed to reveal mutations in 20 sporadic glioblastomas and 16 sporadic oligodendroglial gliomas. Thus, although it is possible that the germline hPMS2 exon 5 mutation may predispose to glioblastomas with an oligodendroglial component, the same genetic defect is not commonly involved in sporadic oligodendrogliomas or glioblastomas.
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Affiliation(s)
- M D Taylor
- Department of Medicine, University of Toronto, Ontario, Canada
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17
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Affiliation(s)
- J G Guillem
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
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18
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Cervoni L, Celli P, Salvati M. Long-term survival in a patient with supratentorial glioblastoma: clinical considerations. ITALIAN JOURNAL OF NEUROLOGICAL SCIENCES 1998; 19:221-4. [PMID: 10933461 DOI: 10.1007/bf02427606] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Glioblastoma, a malignant tumor of neuroepithelial origin, is relatively uncommon in childhood, during which it accounts for 7%-9% of brain tumors. A few patients (about 3%) live more than 5 years. We report a 13-year-old girl who was admitted because one month earlier she had begun to present headache and diplopia. Brain computed tomography (CT) showed a right frontal tumor. At operation, complete excision of the visible tumor was performed. Histologic examination showed that the tumor was a glioblastoma multiforme. The patient underwent 52 Gy of external beam radiotherapy to the enhancing tumor mass plus 3-cm border, and chemotherapy with nitrosourea (BCNU). Fourteen years, 9 months later, the patient presents neither neurological deficits nor radiological relapse. We confirm that younger age, the one immutable prognostic factor, supports a particularly aggressive approach to the treatment of glioblastomas.
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Affiliation(s)
- L Cervoni
- Department of Neurological Sciences, University of Rome La Sapienza, Roma, Italy
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19
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Matsui T, Hayashi N, Yao K, Yao T, Takenaka K, Hoashi T, Takemura S, Iwashita A, Tanaka A, Koga M. A father and son with Turcot's syndrome: evidence for autosomal dominant inheritance: report of two cases. Dis Colon Rectum 1998; 41:797-801. [PMID: 9645753 DOI: 10.1007/bf02236273] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Typical Turcot's syndrome is characterized by the association of a brain glioma together with multiple colonic polyposis, in which the number of polypoid lesions is small and the association of colonic cancer occurs at a younger age than in familial adenomatous polyposis. We describe a family in which both the father and his son presented with typical Turcot's syndrome without parental consanguinity. This is the first report of a family that is considered to follow an autosomal dominant inheritance. After reviewing 25 documented cases in which the average age of death was 20.3 years old, it was learned that the major cause of death was brain tumor (76 percent) and the minor cause was colon cancer (16 percent). Patients were very young and, therefore, unlikely to have produced a child before their death. These facts seem to support the theory that Turcot's syndrome is an autosomal dominant disorder.
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Affiliation(s)
- T Matsui
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan
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20
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Mullins KJ, Rubio A, Myers SP, Korones DN, Pilcher WH. Malignant ependymomas in a patient with Turcot's syndrome: case report and management guidelines. SURGICAL NEUROLOGY 1998; 49:290-4. [PMID: 9508117 DOI: 10.1016/s0090-3019(97)00299-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Turcot's Syndrome is the association of multiple adenomatous polyps of the colon with a primary tumor of the central nervous system. We present the first reported case of Turcot's Syndrome in a patient with malignant ependymomas. Recent advances in the elucidation of the genetic basis for the hereditary forms of colon cancer have provided a clearer understanding of the etiology of Turcot's Syndrome. This new information is relevant to the neurosurgical community and provides updated guidelines in the diagnosis and management of patients with this complex disease process. RESULTS Turcot's Syndrome is related to two distinct genetic errors. The first involves a germ-line mutation in the adenomatous polyposis coli (APC) gene, which is postulated to act as a tumor suppressor gene. The second is a germ-line defect in one of a group of genes responsible for DNA nucleotide mismatch repair. CONCLUSION The elucidation of the gene defects responsible for the hereditary forms of colon cancer has provided a clearer understanding of the molecular basis of Turcot's Syndrome. Patients with hereditary forms of colon cancer and neurologic symptoms require immediate and thorough investigation because of their significantly increased risk of developing CNS tumors. Previously healthy patients diagnosed with a CNS tumor with a family history of adenomatous polyposis coli should undergo screening and surveillance colonoscopy as the CNS lesion may precede colonic symptoms. CNS screening guidelines for asymptomatic patients with adenomatous polyposis coli requires further risk analysis studies. All patients diagnosed with Turcot's Syndrome should be tested for the gene defect, including the CNS tumor tissue to provide further data on the genetic relationship between Turcot's Syndrome and the hereditary forms of colon cancer.
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Affiliation(s)
- K J Mullins
- Division of Neurological Surgery, Strong Memorial Hospital, University of Rochester School of Medicine, New York 14642-8670, USA
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21
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Naganuma H, Sasaki A, Satoh E, Nagasaka M, Isoe S, Nakano S, Nukui H. Long-term survival in a young patient with anaplastic glioma. Brain Tumor Pathol 1998; 14:71-4. [PMID: 9384806 DOI: 10.1007/bf02478872] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 26-year-old man with anaplastic glioma in the left frontoparietal lobe survived for 9 years and 9 months after combined therapy, including subtotal resection, postoperative irradiation, and chemotherapy. The tumor recurred and he received immunotherapy using lymphokine-activated killer (LAK) cells. At the last LAK cell infusion, infection of the Ommaya reservoir occurred, but subsided after antibiotics were administered. Follow-up neuroimaging showed no recurrence of the tumor. Review of the surgical specimens found that the original diagnosis of glioblastoma was inconclusive, although the tumor is considered to be a type of anaplastic glioma.
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Affiliation(s)
- H Naganuma
- Department of Neurosurgery, Yamanashi Medical University, Japan
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22
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Salvati M, Cervoni L, Artico M, Caruso R, Gagliardi FM. Long-term survival in patients with supratentorial glioblastoma. J Neurooncol 1998; 36:61-4. [PMID: 9525826 DOI: 10.1023/a:1017926603341] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The authors report 11 patients with cerebral glioblastoma who lived at least 5 years after their initial diagnosis. There were 6 female and 5 male; the mean age was 39 years (range 24-55 years). All patients were treated surgically and postoperatively received whole-brain radiotherapy and chemotherapy. Five patients (45%) presented local recurrences after an average interval of 3.9 years from treatment. At average follow-up of 9 years (range 5-14 years), 7 patients (64%) were alive after an average interval of 8.1 years; 4 patients (36%) died from local relapse. Survival was influenced by patient age and, to a lesser degree, by treatment. A review of the literature, together with our own series, suggest that death from recurrence disease is unusual in glioblastoma patients who survive more than 5 years.
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Affiliation(s)
- M Salvati
- Department of Neurological Sciences, La Sapienza University of Rome, Italy
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23
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Abstract
A 21-year-old woman was diagnosed with Turcot's syndrome (TS) at age 16 years. She had two ependymomas, one was located in the left middle cerebellar peduncle and the other in the low sacral spinal canal. Her mother and brother both had colectomies for colonic polyposis. Her maternal uncle and grandfather also had this disease and both died from cancer of the colon in their fourth decade of life. The patient was found to have hyperpigmented spots in the retina, skull osteomas and normal neurological examinations. The bone scan and CSF were normal and she had a germline mutation in the segment 3 of the adenomatous polyposis coli (APC) gene. Following partial resection of the two ependymomas, she was treated with radiation and chemotherapy. One year after surgery, paraspinal desmoid tumors were found and removed. She is presently 42 months postsurgical resection of the neural tumors and has remained central nervous system tumor-free. The occurrence of multiple ependymoma in TS has not been reported, and the control of this patient's ependymomas is consistent with other reports of long-term survival with TS and glial tumors.
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Affiliation(s)
- C F Torres
- Department of Neurology, University of Rochester School of Medicine and Dentistry, New York, USA
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24
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25
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Hamilton SR, Liu B, Parsons RE, Papadopoulos N, Jen J, Powell SM, Krush AJ, Berk T, Cohen Z, Tetu B. The molecular basis of Turcot's syndrome. N Engl J Med 1995; 332:839-47. [PMID: 7661930 DOI: 10.1056/nejm199503303321302] [Citation(s) in RCA: 810] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Turcot's syndrome is characterized clinically by the concurrence of a primary brain tumor and multiple colorectal adenomas. We attempted to define the syndrome at the molecular level. METHODS Fourteen families with Turcot's syndrome identified in two registries and the family originally described by Turcot and colleagues were studied. Germ-line mutations in the adenomatous polyposis coli (APC) gene characteristic of familial adenomatous polyposis were evaluated, as well as DNA replication errors and germline mutations in nucleotide mismatch-repair genes characteristic of hereditary nonpolyposis colorectal cancer. In addition, a formal risk analysis for brain tumors in familial adenomatous polyposis was performed with a registry data base. RESULTS Genetic abnormalities were identified in 13 of the 14 registry families. Germ-line APC mutations were detected in 10. The predominant brain tumor in these 10 families was medulloblastoma (11 of 14 patients, or 79 percent), and the relative risk of cerebellar medulloblastoma in patients with familial adenomatous polyposis was 92 times that in the general population (95 percent confidence interval, 29 to 269; P < 0.001). In contrast, the type of brain tumor in the other four families was glioblastoma multiforme. The glioblastomas and colorectal tumors in three of these families and in the original family studied by Turcot had replication errors characteristic of hereditary nonpolyposis colorectal cancer. In addition, germ-line mutations in the mismatch-repair genes hMLH1 or hPMS2 were found in two families. CONCLUSIONS The association between brain tumors and multiple colorectal adenomas can result from two distinct types of germ-line defects: mutation of the APC gene or mutation of a mismatch-repair gene. Molecular diagnosis may contribute to the appropriate care of affected patients.
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Affiliation(s)
- S R Hamilton
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205-2196
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26
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Cervoni L, Celli P, Tarantino R, Fortuna A. Turcot's syndrome: case report and review of the classification. J Neurooncol 1995; 23:63-6. [PMID: 7623070 DOI: 10.1007/bf01058460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We report a case of association of a brain tumor with multiple colorectal polyposis and offer an analysis of the relevant literature with a view to revising the classification of the syndrome in relation to familial multiple polyposis and Gardner's syndrome. Differences emerged, depending on the brain tumor type, which suggests that this association may be classified as two distinct syndromes.
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Affiliation(s)
- L Cervoni
- Department of Neurological Sciences, Neurosurgery La Sapienza University of Rome, Italy
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27
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Organ Culture of a Glioblastoma from a Patient with an Unusually Long Survival. Neurosurgery 1994. [DOI: 10.1097/00006123-199409000-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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28
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Yoshida J, Kajita Y, Wakabayashi T, Sugita K. Long-term follow-up results of 175 patients with malignant glioma: importance of radical tumour resection and postoperative adjuvant therapy with interferon, ACNU and radiation. Acta Neurochir (Wien) 1994; 127:55-9. [PMID: 7942182 DOI: 10.1007/bf01808547] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We analysed long-term follow-up results of 175 patients with malignant glioma (110 glioblastoma and 65 anaplastic astrocytoma) treated under five different regimes during the past two decades. The factors of age (less than 40), histology (anaplastic astrocytoma) and type of adjuvant therapy (radiation and chemotherapy) contributed to long survival. The other important factor was the response to adjuvant therapy. Cases of gross total removal or complete response (CR) of a residual tumour to an adjuvant therapy showed a better prognosis. The three and five year survival rate was 42% and 24%, respectively. The highest CR ratio (23%) was seen in patients treated by intravenous injection of interferon and ACNU in addition to radiotherapy (IAR therapy).
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Affiliation(s)
- J Yoshida
- Department of Neurosurgery, Nagoya University School of Medicine, Japan
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29
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Itoh H, Hirata K, Ohsato K. Turcot's syndrome and familial adenomatous polyposis associated with brain tumor: review of related literature. Int J Colorectal Dis 1993; 8:87-94. [PMID: 8409693 DOI: 10.1007/bf00299334] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We investigated clinical manifestations in 124 patients with a possible Turcot's syndrome whose data were taken from documented cases. The cases were subclassified mainly on the bases of the type of familial occurrence and listed in five Tables. We searched for differences in colonic manifestation, histologic type of glioma, mode of inheritance, frequency of parental consanguinity, skin lesions and other accompanying lesions among these five groups. The differences of these clinical findings suggested that glioma-polyposis syndrome should be classified as follows; (1) cases of Turcot's syndrome who had characteristic colonic and brain manifestations, (2) cases of FAP associated with glioma, (3) suspicious cases of glioma-polyposis, and (4) cases other than glioma-polyposis syndrome.
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Affiliation(s)
- H Itoh
- Department of Surgery I, University of Occupational and Environmental Health, Kitakyushu, Japan
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31
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32
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Schneider T, Victor S. The Turcot syndrome (glioma polyposis) and its neurosurgical significance. Case report. Neurosurg Rev 1993; 16:327-30. [PMID: 8127448 DOI: 10.1007/bf00383845] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We report on a 12-year-old patient with Turcot Syndrome (Glioma polyposis). This patient's case deals with the association between a glioblastoma, anaplastic glioma (WHO Grade III) and colonic adenocarcinoma based on familial polyposis coli. Possible etiology and neurosurgical, clinically important characteristics of this rare syndrome, such as the young age of the patient and the relatively long survival time, will be discussed.
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Affiliation(s)
- T Schneider
- Neurosurgical University Hospital, Knappschaftskrankenhaus Bochum-Langendreer, Fed. Rep. of Germany
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33
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Vertosick FT, Selker RG. Long-term survival after the diagnosis of malignant glioma: a series of 22 patients surviving more than 4 years after diagnosis. SURGICAL NEUROLOGY 1992; 38:359-63. [PMID: 1336626 DOI: 10.1016/0090-3019(92)90022-f] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Long-term survival after the diagnosis of malignant glioma is uncommon but not rare. To define better the population of patients who have extended survival with this disease, we reviewed the records of 22 of our patients who survived more than 4 years after the biopsy-proven diagnosis of anaplastic astrocytoma, malignant mixed glioma, or glioblastoma multiforme. Surprisingly, 21 of the 22 patients are still alive and being actively followed by the authors. The long-term survivors were typically young and with minimal or no functional impairment at the time of diagnosis. Survivals ranged from 4.2 to 15.8 years. The quality of survival was generally good, with the surviving patients having a mean Karnofsky Performance Score of 76. Three-quarters of the patients had no enhancement or mass effect on their most recent computed tomography scans. A review of the available literature, together with our own series, suggests that death from recurrent disease is unusual in glioma patients who survive more than 4 or 5 years.
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Affiliation(s)
- F T Vertosick
- Center for Neuro-Oncology, West Penn Hospital, Pittsburgh, Pennsylvania
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