Abstract
Background and purposePrimary gliosarcoma (GS) is a rare variant of IDH-wildtype glioblastoma multiforme. We performed a single-center analysis to identify prognostic factors.Patients and methodsWe analyzed the records of 26 patients newly diagnosed with primary WHO grade IV GS. Factors of interest were clinical and treatment data, as well as molecular markers, time to recurrence, and time to death.ResultsMedian follow-up was 9 months (range 5–21 months). Gross total resection did not lead to improved survival, most likely due to the relatively small sample size. Low symptom burden at the time of diagnosis was associated with longer PFS (P = 0.023) and OS (P = 0.018). Median OS in the entire cohort was 12 months. Neither MGMT promoter hypermethylation nor adjuvant temozolomide therapy influenced survival, consistent with some previous reports.ConclusionIn this retrospective study, patients exhibiting low symptom burden at diagnosis showed improved survival. None of the other factors analyzed were associated with an altered outcome.
Highlights
Gliosarcoma (GS) is a rare variant of glioblastoma multiforme (GBM), accounting for about 2% of cases [1,2,3]
Neither MGMT promoter hypermethylation nor adjuvant treatment with temozolomide had an impact on survival
In the latest WHO classification, it is regarded as a subtype of the isocitrate dehydrogenase (IDH) wildtype GBM, IDH-mutated GS has been described [1, 11]
Summary
Gliosarcoma (GS) is a rare variant of glioblastoma multiforme (GBM), accounting for about 2% of cases [1,2,3]. It can be divided into primary (de novo) and secondary (after prior GBM treated with radiation) GS [4, 5]. Presenting symptoms include signs of raised intracranial pressure (e.g., headaches, nausea, and vomiting), visual disturbances, or seizures [5, 9]. It is characterized by a biphasic growth pattern, including both a glial and an atypical sarcomatous component, descending from a monoclonal origin [10]. Neither MGMT promoter hypermethylation nor adjuvant temozolomide therapy influenced survival, consistent with some previous reports
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