Primary Spinal Glioblastoma Multiforme Research Articles

Primary spinal glioblastoma multiforme in a pediatric patient: A case report

Primary spinal glioblastoma multiforme in a pediatric patient: A case report

Primary spinal glioblastoma multiforme. Single center experience and literature review

ObjectivesSpinal glioblastomas represent a rare entity accounting for ca 1–3% of all intramedullary tumors; data about survival, prognostic factors and therapeutic protocols are quite poor. Even with an aggressive multimodal management the spinal glioblastoma patients’ survival remains poor, with rapid progression of the disease. This study reports our experience with the management of the primary intramedullary glioblastomas, also in regard to the current literature data. Patients and MethodsWe retrospectively analyzed the medical records of 5 patients treated at the Department for Neuro-oncology and Spine Surgery of the Clinical Center of Belgrade, Serbia, between January 2007 and December 2016 for a primary intramedullary glioblastoma. Demographic characteristics, pre-operative data and post-operative results were then compared with previous literature regarding spinal GBMs and attempt to identify potential prognostic factors. ResultsGross total resection was achieved in two patients, while a subtotal resection was performed in the latter 3 cases; as per protocol, all patients underwent to surgery, followed by radio and chemotherapy. There were no intraoperative complications and no patients developed a new postoperative neurological defect; the median overall survival was 6 months. Progression or recurrence of disease was noted in all patients at the 3-months follow-up, despite the adjuvant treatments. ConclusionsTo the date, there is a lack of consensus on specific management of spinal glioblastomas: the extent of resection can play an important role, but it appears to be not preeminent. A shorter interval between symptoms onset and treatment and a smaller extension of the tumor seem to be correlated with better outcomes and a longer overall survival. However, there is not an adjunctive viable standardized postoperative therapy yet, which results in concrete and persistent improvement of overall survival and progression free survival.

Glioblastoma multiforme of spinal cord – case series in a tertiary cancer centre

Primary spinal cord glioblastoma multiforme (GBM) is a rare clinical condition and is often associated with a dismal prognosis. The standard treatment is maximal safe surgery followed by adjuvant radiotherapy and chemotherapy. Despite such aggressive treatments, the median survival is estimated to be around 15 months in several studies. We report three patients with primary spinal GBM who received treatment in our institute from 2012 to 2019. Among the three, one patient is on long-term follow-up with no evidence of disease, another patient succumbed to the illness and the third patient is having stable disease. Although primary spinal GBM is usually associated with a dismal prognosis, our case series shows a subset of patients will have a favorable outcome with the protocol treatment.

Treatment of a Rare Intramedullary Primary Spinal Glioblastoma Multiforme Lesion in an Adult Patient

Treatment of a Rare Intramedullary Primary Spinal Glioblastoma Multiforme Lesion in an Adult Patient

P15 - Patterns of Care and Survival Outcomes for Patients with Primary Spinal Glioblastoma Multiforme

P15 - Patterns of Care and Survival Outcomes for Patients with Primary Spinal Glioblastoma Multiforme

A systematic review of overall survival in pediatric primary glioblastoma multiforme of the spinal cord.

OBJECTIVE The incidence of primary spinal cord glioblastoma multiforme (GBM) in the pediatric age group is very rare. Only a few case series and case reports have been published in the literature; therefore, overall survival (OS) outcome and the as-yet poorly defined management options are not discussed in detail. The authors performed a cumulative survival analysis of all reported cases of pediatric spinal cord GBM to identify the predictive factors related to final survival outcome. METHODS A comprehensive search for relevant articles was performed on PubMed's electronic database MEDLINE for the period from 1950 to 2015 using the search words "malignant spinal cord tumor" and "spinal glioblastoma multiforme." This study was limited to patients younger than 18 years of age. Survival rates for children with various tumor locations and treatments were collected from the published articles and analyzed. RESULTS After an extensive literature search, 29 articles met the study inclusion criteria. From the detailed information in these articles, the authors found 53 children eligible for the survival analysis. The majority (45%) of the children were more than 12 years old. Thirty-four percent of the cases were between 7 and 12 years of age, and 21% were younger than 7 years. In the Kaplan-Meier survival analysis, children younger than 7 years of age had better survival (13 months) than the children older than 7 years (7-12 years: 10 months, > 12 years: 9 months; p = 0.01, log-rank test). Fifty-five percent of the children were female and 45% were male. A cervical tumor location (32%) was the most common, followed by thoracic (28.3%). Cervicothoracic (18.9%) and conus (18.8%) tumor locations shared the same percentage of cases. Cervical tumors had a worse outcome than tumors in other locations (p = 0.003, log-rank test). The most common presenting symptom was limb weakness (53%), followed by sensory disturbances (25%). Median OS was 10 months. The addition of adjuvant therapy (radiotherapy [RT] and/or chemotherapy [CT]) after surgery significantly improved OS (p = 0.01, log-rank test). Children who underwent gross-total resection and RT had better outcomes than those who underwent subtotal resection and RT (p = 0.04, log-rank test). Cerebrospinal fluid spread, hydrocephalus, brain metastasis, and spinal metastasis were not correlated with OS in primary spinal GBM. CONCLUSIONS Adjuvant therapy after surgery had a beneficial effect on overall outcome of spinal GBM in the pediatric age group. Gross-total resection followed by RT produced a better outcome than subtotal resection with RT. Further large-scale prospective study is required to establish the genetic and molecular factors related to OS in primary GBM of the spinal cord in pediatric patients.

Primary spinal glioblastoma multiforme presenting with leptomeningeal gliomatosis and subarachnoid hemorrhage: A case report

• We present a rare case of spinal GBM with leptomeningeal gliomatosis at the time of diagnosis involving the Brainstem presenting clinically with typical subarachnoid hemorrhage in a 39-year-old female.

Predictive Factors Determining the Overall Outcome of Primary Spinal Glioblastoma Multiforme: An Integrative Survival Analysis

Primary glioblastoma multiforme of the spinal cord is a rare entity. The aim of this study was to perform an integrative analysis of patients whose cases were selected from the published studies, and to examine the influence of various factors on overall outcomes. A PubMed search was performed for literature published from 1938 to 2015 to select the articles containing information about the demographics, tumor location, critical event (death), time to events, and treatment characteristics. One hundred twenty-eight cases of spinal glioblastoma were selected for analysis. Patients between 18 and 65 years of age had a better overall survival rate (14 months) compared with those of "extreme" age outside that range (<18 years, 10.5 months, and >65 years, 2 months; log-rank P = 0.0005). Univariate analysis showed age between 18 and 65 years (hazard ratio [HR] = 0.121; 95% confidence interval [CI] = 0.04-0.37; P = 0.0005) and surgery with radiotherapy (HR = 3.71; 95% CI = 1.36-10.13; P = 0.01) had a significant correlation with overall survival. In multivariate analysis, thoracic spine (odds ratio [OR] = 0.154; 95% CI = 0.033-0.717; P = 0.017) and conus (OR = 0.091; 95% CI = 0.010-0.798; P =0.030) tumor had a lesser chance for mortality at 6 months. Patients who received adjuvant therapy had a better median survival than those who had surgery (log-rank P = 0.0005). In this systemic analysis of primary spinal glioblastoma multiforme, we found that surgery followed by adjuvant therapy (radiotherapy, chemotherapy, or both) was significantly associated with improved survival. The additional finding was that overall median survival was better in the age group of 18-65 years (68 cases) compared with the extremes (<18 years, 53 cases; >65 years, 4 cases).

Treatment of Recurrent Primary Spinal Glioblastoma Multiforme—Case Report

Treatment of Recurrent Primary Spinal Glioblastoma Multiforme—Case Report

Primary glioblastoma multiforme of the medulla spinalis: a report of three cases and review of the literature

Primary spinal glioblastoma multiforme (spinal GBM) is not a very common entity. This paper presents an outline of this rare neoplasm, its clinical presentation, course, management and outcome and reports a 3-case series of spinal GBM. In this 3-case series with spinal GBM, one of the patients was operated for hydrocephalous 10 months later following the tumor surgery and another patient had cerebral metastasis after the surgery. In the postoperative period, two of the cases received radiotherapy and one received combined radiotherapy and chemotherapy with steroid therapy together following the tumor surgery. The review of the pertinent literature has revealed that due to the scarcity of the reported cases of primary spinal GBMs, this issue requires a closer look. GBM behaves more aggressive in medulla spinalis than it behaves when it originates from cerebrum. It may disseminate to the cerebrum during its course and it may cause hydrocephalus due to this dissemination (metastasis).