1
|
Liu L, Shi L, Su Y, Wang K, Wang H. Epidemiological features of spinal intradural tumors, a single-center clinical study in Beijing, China. BMC Musculoskelet Disord 2024; 25:613. [PMID: 39090624 PMCID: PMC11292946 DOI: 10.1186/s12891-024-07741-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 07/26/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Spinal intradural tumors are rare and heterogeneous in histological type, aggressiveness, and symptomatology, and there is a lack of data about them. This study investigated the epidemiological features of spinal intradural tumors. METHODS This retrospective analysis included patients with spinal intradural tumors who underwent surgical treatment at the Myelopathy and Spondylosis Ward Beijing Jishuitan Hospital between January 2012 and December 2022. RESULTS This study included 1321 patients [aged 47.19 ± 14.90 years, 603 (45.65%) males] with spinal intradural tumors. The most common histological subtype was schwannoma [n = 511 (38.68%)], followed by spinal meningioma [n = 184 (13.93%)] and ependymoma [n = 101 (7.65%)]. Fifteen (1.14%) patients were diagnosed with metastatic spinal intradural tumors as a presentation of another primary cancer type. The spinal intradural tumors were mostly found in the lumbar region [n = 436 (33.01%)], followed by the thoracic vertebrae [n = 390 (29.52%)], cervical vertebrae [n = 154 (11.66%)], and thoracolumbar region [n = 111 (8.40%)]. Schwannomas mostly affected the lumbar region [n = 256 (52.64%)], spinal meningiomas in the thoracic region [n = 153 (83.15)], and ependymomas in the lumbar region [56 (55.45%)]. The de novo metastases were mostly found in the lumbar region [n = 8 (53.33%)]. CONCLUSION According to the results of our single-center study, the most common spinal intradural tumor in Northern China is schwannoma, followed by spinal meningioma and ependymoma.
Collapse
Affiliation(s)
- Longqi Liu
- Department of Neurosurgery, Beijing Jishuitan Hospital, Capital Medical University, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China
| | - Liang Shi
- Department of Neurosurgery, Beijing Jishuitan Hospital, Capital Medical University, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China.
| | - Yibing Su
- Department of Neurosurgery, Beijing Jishuitan Hospital, Capital Medical University, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China
| | - Keda Wang
- Department of Neurosurgery, Beijing Jishuitan Hospital, Capital Medical University, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China
| | - Hanbin Wang
- Department of Neurosurgery, Beijing Jishuitan Hospital, Capital Medical University, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China
| |
Collapse
|
2
|
Chaskis E, Silvestri M, Aghakhani N, Parker F, Knafo S. Management and Outcome of Recurring Low-Grade Intramedullary Astrocytomas. Cancers (Basel) 2024; 16:2417. [PMID: 39001480 PMCID: PMC11240503 DOI: 10.3390/cancers16132417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/05/2024] [Accepted: 06/22/2024] [Indexed: 07/16/2024] Open
Abstract
Intramedullary astrocytomas (IMAs) are the second most frequent intramedullary tumors in adults. Low-grade IMAs (LG-IMA, WHO grade I and II) carry a better prognosis than high-grade IMAs (HG-IMAs). However, adjuvant treatment of LG-IMAs by radiotherapy (RT) and/or chemotherapy (CT) as well as treatment of tumor recurrences remains controversial. The aim of our study was to evaluate the postoperative outcome of LG-IMAs and the management of recurring tumors. We retrospectively reviewed a series of patients operated on for IMA from 1980 to 2022 in a single neurosurgical department. We retrieved 40 patients who received surgery for intramedullary astrocytomas, including 30 LG-IMAs (22 WHO grade I; 5 WHO grade II; 3 "low-grade") and 10 HG-IMAs (4 WHO grade III; 5 WHO grade IV; 1 "high-grade"). Of the patients with LG-IMAs, the extent of surgical resection was large (gross or subtotal resection >90%) in 30% of cases. Immediate postoperative radiotherapy and/or chemotherapy was proposed only to patients who underwent biopsy (n = 5), while others were initially followed-up. Over a median follow-up of 59 months (range = 13-376), 16 LG-IMA (53.3%) recurred with a mean delay of 28.5 months after surgery (range = 3-288). These included seven biopsies, five partial resections (PR), four subtotal resections (STR) but no gross total resections (GTR). Progression-free survival for LG-IMAs was 51.9% at 3 years and 35.6% at 5 and 10 years; overall survival was 96.3% at 3 years; 90.9% at 5 years and 81.9% at 10 years. There were no significant differences in terms of OS and PFS between WHO grade I and grade II tumors. However, "large resections" (GTR or STR), as opposed to "limited resections" (PR and biopsies), were associated with both better OS (p = 0.14) and PFS (p = 0.04). The treatment of recurrences consisted of surgery alone (n = 3), surgery with RT and/or CT (n = 2), RT with CT (n = 3), RT alone (n = 2) or CT alone (n = 2). In conclusion, although LG-IMAs are infiltrating tumors, the extent of resection (GTR or STR), but not WHO grading, is the main prognostic factor. The management of recurring tumors is highly variable with no conclusive evidence for either option.
Collapse
Affiliation(s)
- Elly Chaskis
- Department of Neurosurgery, Bicêtre Hospital, AP-HP, 94270 Le Kremlin-Bicêtre, France
| | - Martina Silvestri
- Department of Neurosurgery, Bicêtre Hospital, AP-HP, 94270 Le Kremlin-Bicêtre, France
- Faculty of Medicine, University Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - Nozar Aghakhani
- Department of Neurosurgery, Bicêtre Hospital, AP-HP, 94270 Le Kremlin-Bicêtre, France
- Faculty of Medicine, University Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - Fabrice Parker
- Department of Neurosurgery, Bicêtre Hospital, AP-HP, 94270 Le Kremlin-Bicêtre, France
- Faculty of Medicine, University Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - Steven Knafo
- Department of Neurosurgery, Bicêtre Hospital, AP-HP, 94270 Le Kremlin-Bicêtre, France
- Faculty of Medicine, University Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| |
Collapse
|
3
|
Kayama R, Tsujino K, Kawabata S, Fujikawa Y, Kashiwagi H, Fukuo Y, Hiramatsu R, Takata T, Tanaka H, Suzuki M, Hu N, Miyatake SI, Takami T, Wanibuchi M. Translational research of boron neutron capture therapy for spinal cord gliomas using rat model. Sci Rep 2024; 14:8265. [PMID: 38594281 PMCID: PMC11003979 DOI: 10.1038/s41598-024-58728-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/02/2024] [Indexed: 04/11/2024] Open
Abstract
Boron neutron capture therapy (BNCT) is a type of targeted particle radiation therapy with potential applications at the cellular level. Spinal cord gliomas (SCGs) present a substantial challenge owing to their poor prognosis and the lack of effective postoperative treatments. This study evaluated the efficacy of BNCT in a rat SCGs model employing the Basso, Beattie, and Bresnahan (BBB) scale to assess postoperative locomotor activity. We confirmed the presence of adequate in vitro boron concentrations in F98 rat glioma and 9L rat gliosarcoma cells exposed to boronophenylalanine (BPA) and in vivo tumor boron concentration 2.5 h after intravenous BPA administration. In vivo neutron irradiation significantly enhanced survival in the BNCT group when compared with that in the untreated group, with a minimal BBB scale reduction in all sham-operated groups. These findings highlight the potential of BNCT as a promising treatment option for SCGs.
Collapse
Affiliation(s)
- Ryo Kayama
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki City, Osaka, Japan
| | - Kohei Tsujino
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki City, Osaka, Japan
| | - Shinji Kawabata
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki City, Osaka, Japan.
| | - Yoshiki Fujikawa
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki City, Osaka, Japan
| | - Hideki Kashiwagi
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki City, Osaka, Japan
| | - Yusuke Fukuo
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki City, Osaka, Japan
| | - Ryo Hiramatsu
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki City, Osaka, Japan
| | - Takashi Takata
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, 2 Asashiro-Nishi, Kumatori-Cho, Sennan-Gun, Osaka, Japan
| | - Hiroki Tanaka
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, 2 Asashiro-Nishi, Kumatori-Cho, Sennan-Gun, Osaka, Japan
| | - Minoru Suzuki
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, 2 Asashiro-Nishi, Kumatori-Cho, Sennan-Gun, Osaka, Japan
| | - Naonori Hu
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki City, Osaka, Japan
| | - Shin-Ichi Miyatake
- Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki City, Osaka, Japan
| | - Toshihiro Takami
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki City, Osaka, Japan
| | - Masahiko Wanibuchi
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki City, Osaka, Japan
| |
Collapse
|
4
|
Willman M, Willman J, Figg J, Dioso E, Sriram S, Olowofela B, Chacko K, Hernandez J, Lucke-Wold B. Update for astrocytomas: medical and surgical management considerations. EXPLORATION OF NEUROSCIENCE 2023; 2:1-26. [PMID: 36935776 PMCID: PMC10019464 DOI: 10.37349/en.2023.00009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/10/2022] [Indexed: 02/25/2023]
Abstract
Astrocytomas include a wide range of tumors with unique mutations and varying grades of malignancy. These tumors all originate from the astrocyte, a star-shaped glial cell that plays a major role in supporting functions of the central nervous system (CNS), including blood-brain barrier (BBB) development and maintenance, water and ion regulation, influencing neuronal synaptogenesis, and stimulating the immunological response. In terms of epidemiology, glioblastoma (GB), the most common and malignant astrocytoma, generally occur with higher rates in Australia, Western Europe, and Canada, with the lowest rates in Southeast Asia. Additionally, significantly higher rates of GB are observed in males and non-Hispanic whites. It has been suggested that higher levels of testosterone observed in biological males may account for the increased rates of GB. Hereditary syndromes such as Cowden, Lynch, Turcot, Li-Fraumeni, and neurofibromatosis type 1 have been linked to increased rates of astrocytoma development. While there are a number of specific gene mutations that may influence malignancy or be targeted in astrocytoma treatment, O 6-methylguanine-DNA methyltransferase (MGMT) gene function is an important predictor of astrocytoma response to chemotherapeutic agent temozolomide (TMZ). TMZ for primary and bevacizumab in the setting of recurrent tumor formation are two of the main chemotherapeutic agents currently approved in the treatment of astrocytomas. While stereotactic radiosurgery (SRS) has debatable implications for increased survival in comparison to whole-brain radiotherapy (WBRT), SRS demonstrates increased precision with reduced radiation toxicity. When considering surgical resection of astrocytoma, the extent of resection (EoR) is taken into consideration. Subtotal resection (STR) spares the margins of the T1 enhanced magnetic resonance imaging (MRI) region, gross total resection (GTR) includes the margins, and supramaximal resection (SMR) extends beyond the margin of the T1 and into the T2 region. Surgical resection, radiation, and chemotherapy are integral components of astrocytoma treatment.
Collapse
Affiliation(s)
- Matthew Willman
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jonathan Willman
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - John Figg
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Emma Dioso
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
| | - Sai Sriram
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Bankole Olowofela
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Kevin Chacko
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jairo Hernandez
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| |
Collapse
|
5
|
A Case-report of Concurrent Pulmonary and Cerebral Lesions in a Patient with Polymyositis: Invasive Aspergillosis or Astrocytoma? Jundishapur J Microbiol 2023. [DOI: 10.5812/jjm-132821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction: Polymyositis is an idiopathic inflammatory myopathy that mainly manifests itself in muscle weakness. Patients with polymyositis have a higher risk of developing infections and malignancies. We report concurrent pulmonary and cerebral lesions in a polymyositis patient with many diagnostic challenges. Case Presentation: A 56-year-old woman complained of a productive cough and dyspnea two weeks ago. Her symptoms gradually progressed until a sudden loss of consciousness occurred. She was a known case of polymyositis and was treated with oral prednisolone. Imaging revealed concurrent pulmonary and cerebral lesions. Initially, the patient underwent empirical therapy. However, the patient underwent a bronchoscopy because she did not respond to treatment. Specimens obtained from respiratory secretions revealed branched septate hyphae, and the culture was positive for Aspergillus fumigatus. She was diagnosed with invasive aspergillosis, so we replaced the therapy with voriconazole. After three months, the lung lesions improved, but the number and extent of cerebral lesions increased. Finally, after a stereotactic biopsy, the patient was diagnosed with astrocytoma and became a candidate for radiotherapy. Conclusions: Patients with polymyositis are prone to contracting opportunistic infections and malignancies. Both of them can mimic each other and present diagnostic challenges to physicians. Thus, they should think about them for early diagnosis and timely treatment.
Collapse
|
6
|
The Role of Cellular Immunity and Adaptive Immunity in Pathophysiology of Brain and Spinal Cord Tumors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1394:51-72. [PMID: 36587381 DOI: 10.1007/978-3-031-14732-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Major advances have been made in our understanding of CNS tumors, especially glioma, however, the survival of patients with malignant glioma remains poor. While radiation and chemotherapy have increased overall survival, glioblastoma multiforme (GBM) still has one of the worst 5-year survival rates of all human cancers. Here, in this chapter, the authors review the abrogation of the immune system in the tumor setting, revealing many plausible targets for therapy and the current immunotherapy treatment strategies employed. Notably, glioma has also been characterized as a subset of primary spinal cord tumor and current treatment recommendations are outlined here.
Collapse
|
7
|
TARHAN N, ARSLAN M. Determination of Factors Influencing Pharmacists While Recommending Immune-Enhancing Products via Analytic Hierarchy Process. Turk J Pharm Sci 2022; 19:701-705. [PMID: 36544400 PMCID: PMC9780582 DOI: 10.4274/tjps.galenos.2022.02686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objectives Immune enhancers are attracting attention day by day. Besides, during the coronavirus disease-2019 (COVID-19) pandemic, there has been an increasing demand for immune enhancers. Pharmacists are seen as trustable providers of complementary and alternative medicines, dietary and herbal supplements, immune-enhancers, and so on. This study aims to prioritization criteria that affect community pharmacists' recommending behavior regarding immune enhancers. Materials and Methods This paper adopts the analytic hierarchy process (AHP) to rank different criteria substantial for affecting community pharmacists' recommending behavior regarding immune enhancers. In this direction, firstly seven criteria were identified through literature review and views of pharmacists who have community pharmacy experiences. These are; (i) ease of access, (ii) selling price, (iii) package, (iv) content (appropriateness to patient health status), (v) expectation of patient, (vi) quality, and (vii) trust in the manufacturer. Then, a questionnaire including criteria was prepared and delivered to community pharmacists. The data obtained from 93 participants were transferred to the Super Decisions software. The hierarchical structure of the AHP was established and pair-wise comparisons were made. Results This study showed that the most important criterion was the ease of access (28%). Secondly, pharmacists give importance to the content of the product, while advising immune-enhancers (22%). Besides, it was determined that the least important criterion was the package of the product (4%). Conclusion This study will contribute to the literature by facilitating the process of assessing factors that pharmacists pay attention to while recommending immune-enhancing products. Additionally, the present study results will shed light on firms producing such products, to shape their supply chain management strategies, especially for marketing and sales.
Collapse
Affiliation(s)
- Nilay TARHAN
- İzmir Katip Çelebi University, Faculty of Pharmacy, Department of Pharmacy Management, İzmir, Türkiye,* Address for Correspondence: Phone: +90 232 329 35 35/6121 E-mail:
| | - Miray ARSLAN
- Van Yüzüncü Yıl University, Faculty of Pharmacy, Department of Pharmacy Management, Van, Türkiye
| |
Collapse
|
8
|
Zhuo Z, Zhang J, Duan Y, Qu L, Feng C, Huang X, Cheng D, Xu X, Sun T, Li Z, Guo X, Gong X, Wang Y, Jia W, Tian D, Zhang X, Shi F, Haller S, Barkhof F, Ye C, Liu Y. Automated Classification of Intramedullary Spinal Cord Tumors and Inflammatory Demyelinating Lesions Using Deep Learning. Radiol Artif Intell 2022; 4:e210292. [PMID: 36523644 PMCID: PMC9745442 DOI: 10.1148/ryai.210292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 07/27/2022] [Accepted: 08/24/2022] [Indexed: 05/13/2023]
Abstract
Accurate differentiation of intramedullary spinal cord tumors and inflammatory demyelinating lesions and their subtypes are warranted because of their overlapping characteristics at MRI but with different treatments and prognosis. The authors aimed to develop a pipeline for spinal cord lesion segmentation and classification using two-dimensional MultiResUNet and DenseNet121 networks based on T2-weighted images. A retrospective cohort of 490 patients (118 patients with astrocytoma, 130 with ependymoma, 101 with multiple sclerosis [MS], and 141 with neuromyelitis optica spectrum disorders [NMOSD]) was used for model development, and a prospective cohort of 157 patients (34 patients with astrocytoma, 45 with ependymoma, 33 with MS, and 45 with NMOSD) was used for model testing. In the test cohort, the model achieved Dice scores of 0.77, 0.80, 0.50, and 0.58 for segmentation of astrocytoma, ependymoma, MS, and NMOSD, respectively, against manual labeling. Accuracies of 96% (area under the receiver operating characteristic curve [AUC], 0.99), 82% (AUC, 0.90), and 79% (AUC, 0.85) were achieved for the classifications of tumor versus demyelinating lesion, astrocytoma versus ependymoma, and MS versus NMOSD, respectively. In a subset of radiologically difficult cases, the classifier showed an accuracy of 79%-95% (AUC, 0.78-0.97). The established deep learning pipeline for segmentation and classification of spinal cord lesions can support an accurate radiologic diagnosis. Supplemental material is available for this article. © RSNA, 2022 Keywords: Spinal Cord MRI, Astrocytoma, Ependymoma, Multiple Sclerosis, Neuromyelitis Optica Spectrum Disorder, Deep Learning.
Collapse
|
9
|
Hersh AM, Antar A, Pennington Z, Aygun N, Patel J, Goldsborough E, Porras JL, Elsamadicy AA, Lubelski D, Wolinsky JP, Jallo GI, Gokaslan ZL, Lo SFL, Sciubba DM. Predictors of survival and time to progression following operative management of intramedullary spinal cord astrocytomas. J Neurooncol 2022; 158:117-127. [PMID: 35538385 DOI: 10.1007/s11060-022-04017-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/15/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Surgical resection is considered standard of care for primary intramedullary astrocytomas, but the infiltrative nature of these lesions often precludes complete resection without causing new post-operative neurologic deficits. Radiotherapy and chemotherapy serve as potential adjuvants, but high-quality data evaluating their efficacy are limited. Here we analyze the experience at a single comprehensive cancer center to identify independent predictors of postoperative overall and progression-free survival. METHODS Data was collected on patient demographics, tumor characteristics, pre-operative presentation, resection extent, long-term survival, and tumor progression/recurrence. Kaplan-Meier curves modeled overall and progression-free survival. Univariable and multivariable accelerated failure time regressions were used to compute time ratios (TR) to determine predictors of survival. RESULTS 94 patients were included, of which 58 (62%) were alive at last follow-up. On multivariable analysis, older age (TR = 0.98; p = 0.03), higher tumor grade (TR = 0.12; p < 0.01), preoperative back pain (TR = 0.45; p < 0.01), biopsy [vs GTR] (TR = 0.18; p = 0.02), and chemotherapy (TR = 0.34; p = 0.02) were significantly associated with poorer survival. Higher tumor grade (TR = 0.34; p = 0.02) and preoperative bowel dysfunction (TR = 0.31; p = 0.02) were significant predictors of shorter time to detection of tumor growth. CONCLUSION Tumor grade and chemotherapy were associated with poorer survival and progression-free survival. Chemotherapy regimens were highly heterogeneous, and randomized trials are needed to determine if any optimal regimens exist. Additionally, GTR was associated with improved survival, and patients should be counseled about the benefits and risks of resection extent.
Collapse
Affiliation(s)
- Andrew M Hersh
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Albert Antar
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Zach Pennington
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Nafi Aygun
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiologic Science, The Johns Hopkins Hospital, Baltimore, MD, 21287, USA
| | - Jaimin Patel
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Earl Goldsborough
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Jose L Porras
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | | | - Daniel Lubelski
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Jean-Paul Wolinsky
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - George I Jallo
- Department of Neurosurgery, Johns Hopkins Medicine, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Ziya L Gokaslan
- Department of Neurosurgery, Brown University, Providence, RI, USA
| | - Sheng-Fu Larry Lo
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center, North Shore University Hospital, Northwell Health, Manhasset, NY, 11030, USA
| | - Daniel M Sciubba
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- Department of Neurosurgery, Brown University, Providence, RI, USA.
- , 300 Community Dr., 9 Tower, Manhasset, NY, 11030, USA.
| |
Collapse
|
10
|
Konovalov N, Timonin S, Asyutin D, Raevskiy M, Sorokin M, Buzdin A, Kaprovoy S. Transcriptomic Portraits and Molecular Pathway Activation Features of Adult Spinal Intramedullary Astrocytomas. Front Oncol 2022; 12:837570. [PMID: 35387112 PMCID: PMC8978956 DOI: 10.3389/fonc.2022.837570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/21/2022] [Indexed: 11/30/2022] Open
Abstract
In this study, we report 31 spinal intramedullary astrocytoma (SIA) RNA sequencing (RNA-seq) profiles for 25 adult patients with documented clinical annotations. To our knowledge, this is the first clinically annotated RNA-seq dataset of spinal astrocytomas derived from the intradural intramedullary compartment. We compared these tumor profiles with the previous healthy central nervous system (CNS) RNA-seq data for spinal cord and brain and identified SIA-specific gene sets and molecular pathways. Our findings suggest a trend for SIA-upregulated pathways governing interactions with the immune cells and downregulated pathways for the neuronal functioning in the context of normal CNS activity. In two patient tumor biosamples, we identified diagnostic KIAA1549-BRAF fusion oncogenes, and we also found 16 new SIA-associated fusion transcripts. In addition, we bioinformatically simulated activities of targeted cancer drugs in SIA samples and predicted that several tyrosine kinase inhibitory drugs and thalidomide analogs could be potentially effective as second-line treatment agents to aid in the prevention of SIA recurrence and progression.
Collapse
Affiliation(s)
| | | | | | - Mikhail Raevskiy
- Omicsway Corp., Walnut, CA, United States
- Moscow Institute of Physics and Technology, Moscow, Russia
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Maxim Sorokin
- Moscow Institute of Physics and Technology, Moscow, Russia
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Anton Buzdin
- Omicsway Corp., Walnut, CA, United States
- Moscow Institute of Physics and Technology, Moscow, Russia
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Oncobox Ltd., Moscow, Russia
| | | |
Collapse
|
11
|
AlRaddadi KK, Farrash F, Baeesa S, Alkhani AM. Primary spinal intramedullary astrocytomas; long-term outcomes and literature review. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2021.101401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
12
|
Grady C, Melnick K, Porche K, Dastmalchi F, Hoh DJ, Rahman M, Ghiaseddin A. Glioma Immunotherapy: Advances and Challenges for Spinal Cord Gliomas. Neurospine 2022; 19:13-29. [PMID: 35130421 PMCID: PMC8987559 DOI: 10.14245/ns.2143210.605] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/21/2021] [Indexed: 01/05/2023] Open
Abstract
Spinal cord gliomas are rare entities that often have limited surgical options. Immunotherapy has shown promise in intracranial gliomas with some research suggesting benefit for spinal cord gliomas. A focused review of immunotherapies that have been investigated in spinal cord gliomas was performed. The primary methods of immunotherapy investigated in spinal cord gliomas include immune checkpoint inhibitors, adoptive T-cell therapies, and vaccine strategies. There are innumerable challenges that must be overcome to effectively apply immunotherapeutic strategies to the spinal cord gliomas including low incidence, few antigenic targets, the blood spinal cord barrier, the immunosuppressive tumor microenvironment and neurotoxic treatment effects. Nonetheless, research has suggested ways to overcome these challenges and treatments have been effective in case reports for metastatic non-small cell lung cancer, melanoma, midline glioma and glioblastoma. Current therapies for spinal cord gliomas are markedly limited. Further research is needed to determine if the success of immunotherapy for intracranial gliomas can be effectively applied to these unique tumors.
Collapse
Affiliation(s)
- Clare Grady
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Kaitlyn Melnick
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA,Corresponding Author Kaitlyn Melnick https://orcid.org/0000-0002-2657-2176 Department of Neurosurgery, University of Florida, Box 100265, Gainesville, FL, USA
| | - Ken Porche
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Farhad Dastmalchi
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Daniel J. Hoh
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Maryam Rahman
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Ashley Ghiaseddin
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| |
Collapse
|
13
|
Zhdan VM, Volchenko HV, Babanina M. MY, Tkachenko MV, Kyrian OA. AXIAL SPONDYLOARTHRITIS. CLINICAL DEFINITION AND DIAGNOSTIC APPROACHES. BULLETIN OF PROBLEMS BIOLOGY AND MEDICINE 2022. [DOI: 10.29254/2077-4214-2022-4-167-49-58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
14
|
Hachicha A, Belhaj A, Karmeni N, Slimane A, Bouali S, Kallel J. Intramedullary spinal cord tumors: A retrospective multicentric study. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2021; 12:269-278. [PMID: 34728994 PMCID: PMC8501820 DOI: 10.4103/jcvjs.jcvjs_64_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022] Open
Abstract
CONTEXT Intramedullary tumors are neoformations taking part on the spinal cord, and they are a rare pathology. Due to the rarity of such lesions, clinical studies take years to ensure a decent feedback with a significant number of cases. DESIGN Our study is retrospective and descriptive. PARTICIPANTS We share a Tunisian multicentric experience of 27 years through a retrospective study of 120 cases of spinal cord tumors that have been operated in six different centers. OUTCOME MEASURES The clinical, radiological, and histological findings have been analyzed along with postoperative results and tumoral progression so that we could conclude to some factors of prognosis concerning the management of these tumors. RESULTS The mean age of our patients is 33.84 years. We had 57 males and 63 females. The most frequent revealing symptom was motor trouble presented as frequent as 77.5% of the patients. Glial tumors were represented in 81 of the cases (67.5%) and nonglial by 39 cases (32.5%). Glial tumors we found were essentially 39 ependymomas and 35 astrocytomas. Surgical resection is key in the management of these lesions; the quality of tumoral resection was a significant factor of disease progression as subtotal resection is correlated to more important progression than total one. CONCLUSION We conclude this work with some statements. In terms of functional results, age is not a significant factor. Presurgical functional state, the histological type, and the extent of surgical resection are the important factors.
Collapse
Affiliation(s)
- Anis Hachicha
- Department of Neurosurgery, Tunisia Faculty of Medicine, National Institute of Neurology Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ala Belhaj
- Department of Neurosurgery, Tunisia Faculty of Medicine, National Institute of Neurology Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nadhir Karmeni
- Department of Neurosurgery, Tunisia Faculty of Medicine, National Institute of Neurology Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Abdelhafidh Slimane
- Department of Neurosurgery, Tunisia Faculty of Medicine, National Institute of Neurology Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sofiene Bouali
- Department of Neurosurgery, Tunisia Faculty of Medicine, National Institute of Neurology Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Jalel Kallel
- Department of Neurosurgery, Tunisia Faculty of Medicine, National Institute of Neurology Tunis, University of Tunis El Manar, Tunis, Tunisia
| |
Collapse
|
15
|
Zabsonre SD, Bambara AT, Ouattara S, Traore A, Kafando AJK, Dabilgou AA, Klamadji S, Haro Y, Dao I, Kinda B, Kabre A. [Histological profile and progression of intraspinal tumors after surgery]. Pan Afr Med J 2021; 38:128. [PMID: 33912298 PMCID: PMC8051254 DOI: 10.11604/pamj.2021.38.128.21214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 01/14/2020] [Indexed: 11/11/2022] Open
Abstract
Les tumeurs intrarachidiennes sont peu fréquentes. Leur diagnostic positif est basé sur l´imagerie médicale surtout l´IRM. L´anatomopathologie apporte la certitude du diagnostic. La chirurgie est le traitement de choix pour la plupart d´entre elles. Le pronostic est fonction de la nature histologique et de l´état clinique initial du patient. Nous rapportons le profil histologique et l´évolution des tumeurs intra rachidiennes opérées dans notre service. Il s´agissait d´une étude rétrospective sur une période 10 ans. Ont été inclus les cas opérés confirmés à l´histologie (23 cas). Quatre dossiers non exploitables ont été exclus. Les patients ont consulté en moyenne 79 jours après les premiers symptômes pour un syndrome de compression médullaire lente dans 11 cas. Sept TDM et 14 IRM permettaient d´objectiver 4 tumeurs intramédullaires, 9 intradurales, 1 extra durale et 5 localisations non précises. L´histologie concluait à un méningiome dans 11 cas, un neurinome dans 3 cas. Elle a conclu au même diagnostic que l´imagerie médicale dans 7 cas (4 TDM et 3 IRM). L´exérèse était macroscopiquement complète dans 14 cas, partielle dans 5 cas. Après un recul de 6 mois, 6 patients avaient récupéré totalement, 9 partiellement. Le diagnostic était tardif. L´IRM décrivait mieux la lésion, mais était limitée dans l´approche histologique. Les méningiomes dominaient. L´exérèse était le plus souvent complète. Les suites opératoires étaient favorables.
Collapse
Affiliation(s)
- Sylvain Denléwendé Zabsonre
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Augustin Tozoula Bambara
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Souleymane Ouattara
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Adama Traore
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Adeline Julie Kyelem Kafando
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Alfred Aselme Dabilgou
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Stéphane Klamadji
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Yacouba Haro
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Ibrahim Dao
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Boureima Kinda
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Abel Kabre
- Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| |
Collapse
|
16
|
Wang GH, Wang LY, Zhang C, Zhang P, Wang CH, Cheng S. MiR-1225-5p acts as tumor suppressor in glioblastoma via targeting FNDC3B. Open Med (Wars) 2020; 15:872-881. [PMID: 33336045 PMCID: PMC7712056 DOI: 10.1515/med-2020-0156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/06/2020] [Accepted: 07/17/2020] [Indexed: 11/15/2022] Open
Abstract
This study attempted to research the molecular mechanism underlying the inhibitory role of miR-1225-5p in the malignant progression of glioblastoma. Bioinformatics analyses based on the gene expression omnibus (GEO) and Chinese glioma genome atlas (CGGA) databases showed that miR-1225-5p, as a favorable prognostic factor, was expressed at low levels in glioblastoma, and its expression was also related to WHO grade and age. The subsequent CCK-8 assay indicated that miR-1225-5p might prevent the malignant progression of glioblastoma, which was represented by that miR-1225-5p mimic reduced the viability of glioblastoma cells. Then, we predicted that FNDC3B might be a potential target gene of miR-1225-5p, and it was negatively correlated with the level of miR-1225-5p, which were confirmed by dual-luciferase reporter assay, qRT-PCR and western blot assays. Moreover, based on the analyses of the cancer genome atlas (TCGA), Oncomine and CGGA databases, FNDC3B was enriched in glioblastoma and high expression of FNDC3B led to poor prognosis. Finally, CCK8 and transwell experiments showed that the ability of miR-1225-5p to inhibit glioblastoma cell viability, invasion and migration was at least partially achieved by targeting FNDC3B. In general, these results revealed that the miR-1225-5p/FNDC3B axis contributes to inhibiting the malignant phenotype of glioblastoma cells, which lays a foundation for molecular diagnosis and treatment of glioblastoma.
Collapse
Affiliation(s)
- Guo-Hua Wang
- Department of Neurosurgery, Sunshine Union Hospital of Shandong Province, No. 9000 Yingqian Street, Weifang, Shandong, 261000, People's Republic of China
| | - Liang-Yan Wang
- Department of Ophthalmology, The Affiliated Hospital of Weifang Medical University, Weifang, Shandong , 261000, People's Republic of China
| | - Cui Zhang
- Department of Neurosurgery, Sunshine Union Hospital of Shandong Province, No. 9000 Yingqian Street, Weifang, Shandong, 261000, People's Republic of China
| | - Peng Zhang
- Department of Neurosurgery, Sunshine Union Hospital of Shandong Province, No. 9000 Yingqian Street, Weifang, Shandong, 261000, People's Republic of China
| | - Chuan-Hui Wang
- Department of Neurosurgery, Sunshine Union Hospital of Shandong Province, No. 9000 Yingqian Street, Weifang, Shandong, 261000, People's Republic of China
| | - Shuai Cheng
- Department of Neurosurgery, Sunshine Union Hospital of Shandong Province, No. 9000 Yingqian Street, Weifang, Shandong, 261000, People's Republic of China
| |
Collapse
|
17
|
Butenschoen VM, Hubertus V, Janssen IK, Onken J, Wipplinger C, Mende KC, Eicker SO, Kehl V, Thomé C, Vajkoczy P, Schaller K, Gempt J, Meyer B, Wostrack M. Surgical treatment and neurological outcome of infiltrating intramedullary astrocytoma WHO II-IV: a multicenter retrospective case series. J Neurooncol 2020; 151:181-191. [PMID: 33094355 PMCID: PMC7875841 DOI: 10.1007/s11060-020-03647-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/09/2020] [Indexed: 01/19/2023]
Abstract
Introduction Primary malignant spinal astrocytomas present rare oncological entities with limited median survival and rapid neurological deterioration. Evidence on surgical therapy, adjuvant treatment, and neurological outcome is sparse. We aim to describe the treatment algorithm and clinical features on patients with infiltrating intramedullary astrocytomas graded WHO II–IV. Methods The following is a multicentered retrospective study of patients treated for spinal malignant glioma WHO II–IV in five high-volume neurosurgical departments from 2008 to 2019. Pilocytic astrocytomas were excluded. We assessed data on surgical technique, perioperative neurological status, adjuvant oncological therapy, and clinical outcome. Results 40 patients were included (diffuse astrocytoma WHO II n = 11, anaplastic astrocytoma WHO III n = 12, WHO IV n = 17). Only 40% were functionally independent before surgery, most patients presented with moderate disability (47.5%). Most patients underwent a biopsy (n = 18, 45%) or subtotal tumor resection (n = 15, 37.5%), and 49% of the patients deteriorated after surgery. Patients with WHO III and IV tumors were treated with combined radiochemotherapy. Median overall survival (OS) was 46.5 months in WHO II, 25.7 months in WHO III, and 7.4 months in WHO IV astrocytomas. Preoperative clinical status and WHO significantly influenced the OS, and the extent of resection did not. Conclusion Infiltrating intramedullary astrocytomas WHO II–IV present rare entities with dismal prognosis. Due to the high incidence of surgery-related neurological impairment, the aim of the surgical approach should be limited to obtaining the histological tissue via a biopsy or, tumor debulking in cases with rapidly progressive severe preoperative deficits.
Collapse
Affiliation(s)
- Vicki M Butenschoen
- Department of Neurosurgery, School of Medicine, Klinikum Rechts Der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany.
| | - Vanessa Hubertus
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Insa K Janssen
- Department of Neurosurgery, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Julia Onken
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Christoph Wipplinger
- Department of Neurosurgery, University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Klaus C Mende
- Department of Neurosurgery, University Hospital Hamburg Eppendorf, Martinistraße 52, 20251, Hamburg, Germany
| | - Sven O Eicker
- Department of Neurosurgery, University Hospital Hamburg Eppendorf, Martinistraße 52, 20251, Hamburg, Germany
| | - Victoria Kehl
- School of Medicine, Institute of Medical Informatics, Statistics and Epidemiology, Technical University Munich, Grillparzerstr. 18, 81675, Munich, Germany
| | - Claudius Thomé
- Department of Neurosurgery, University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Karl Schaller
- Department of Neurosurgery, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Jens Gempt
- Department of Neurosurgery, School of Medicine, Klinikum Rechts Der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, School of Medicine, Klinikum Rechts Der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Maria Wostrack
- Department of Neurosurgery, School of Medicine, Klinikum Rechts Der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| |
Collapse
|