title: Gliosarcomas: analysis of 11 cases do two subtypes exist?
abstract: There are conflicting reports regarding gliosarcomas. The goal of this study is to examine clinical, radiological, surgical and therapeutic aspects of 11 patients with gliosarcoma. Between 1993 and 2001, 11 patients with cerebral gliosarcoma were treated at our Institute. Ten patients underwent surgery and one patient had stereotactic biopsy. Four patients received whole brain radiotherapy with (60)Co, five underwent radiotherapy with LINAC extended 2 cm beyond the edema margins. One patient refused any additional treatment after surgery and one patient was not treated postoperatively for poor clinical conditions (KPS 40). Chemotherapy (temozolomide) was administered to four patients. Four patients had a prevalence of sarcomatous component that corresponded to surgical and radiological aspects similar to meningioma while six patients showed a prevalence of gliomatous component and radiological and surgical aspects similar to those of glioblastomas. Surgical resection was total in six and subtotal in four patients. Patients with prevalent sarcomatous component showed median survival time more prolonged than patients with prevalent gliomatous component (71 +/- 6 weeks vs. 63 +/- 6; P=0.0417). Moreover, the survival rate differed in relation to the therapy: patients treated with multimodality therapy (surgery, radiotherapy and chemotherapy) had a longer survival time than patients treated in single or bimodality. Despite prognosis of gliosarcomas remains poor, a multidisciplinary approach (surgery, radiotherapy and chemotherapy) seems to be associated with slight more prolonged survival times.
authors.affiliation: Department of Neurological Sciences - Neurosurgery, INM Neuromed IRCCS, Pozzilli (Is), Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Salvati
authors.forename: Emanuela
authors.initials: E
authors.lastname: Caroli
authors.forename: Antonino
authors.initials: A
authors.lastname: Raco
authors.forename: Felice
authors.initials: F
authors.lastname: Giangaspero
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrante
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D018316:Gliosarcoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed