Abstract
ObjectiveMetastatic spinal dissemination (MSD) of supratentorial glioma is very rare and there is no established standard of care. The current study investigates the clinical characteristics and course of spinal dissemination of supratentorial glioma.MethodsA retrospective analysis of adult patients with MSD of supratentorial glioma treated in the Department of Oncology in Beijing Shijitan Hospital, Capital Medical University from June 2012 until August 2021 was performed. The time to event was estimated using Kaplan–Meier analysis. Univariate analyses were performed using log-rank test and multivariate analysis was performed using the Cox proportional hazards model.ResultsThirty-four adult patients with MSD of supratentorial glioma were enrolled in this retrospective study. The median time to MSD (TTMSD) and overall survival (OS) were 5 months (range: 0–78 months) and 15 months (range: 0.7–85 months), respectively, in the entire cohort. Univariate analysis demonstrated that the patients who had received TMZ therapy had a longer TTMSD than those who did not (mTTMSD: 15 vs. 3 months, log-rank P = 0.0004). Furthermore, a protracted duration of salvage chemotherapy of >6 months after MSD was associated with longer OS of the patients with MSD of supratentorial glioma (mOS: 13 vs. 5 months, log-rank P = 0.0163) and reduced the death risk by 64.3% (hazard ratio: 0.357, 95% CI: 0.141–0.901, P = 0.029) compared with a duration ≤6 months.ConclusionPatients with MSD of supratentorial glioma experienced poor prognosis and adjuvant chemotherapy may delay the occurrence of MSD. The protracted duration of systemic salvage chemotherapy may favor survival after spinal dissemination.
Highlights
Gliomas are the most common primary tumor in the brain and lead to most brain cancer-related deaths [1, 2]
Patients with metastatic spinal dissemination (MSD) of supratentorial glioma treated in Beijing Shijitan Hospital between June 2011 and August 2021 were eligible for in this retrospective study, and the demographic, treatment, and survival data were collected for analysis
We found that the duration >6 months was observed in seven patients, while five patients received systemic therapy for >10 months after spinal dissemination
Summary
Gliomas are the most common primary tumor in the brain and lead to most brain cancer-related deaths [1, 2]. The metastatic spread of glioma is uncommon and typically occurs within the neuroaxis. Among the types of the rare metastatic spread in the neuroaxis, spinal dissemination defined as the involvement of the spinal cord is a less common type of extracranially metastatic spread compared with the spread in intracranial cavity [8, 9]. Considering the low incidence of spinal dissemination of glioma, there is currently no standard of care established and the prognosis remains very poor [10, 11]. We present a retrospective study of over 9 years of experience in our clinic to better understand the clinical course and characteristics of spinal dissemination of supratentorial glioma
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