Adult gliosarcoma: epidemiology, natural history, and factors associated with outcome.
The epidemiology and natural history of adult gliosarcomas (GSMs), as well as patient and treatment factors associated with outcome, are ill defined. Patients over 20 years of age with GSM diagnosed from 1988 to 2004 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival analysis and Cox models were used to examine outcomes. Similar analyses were conducted for patients diagnosed with glioblastoma (GBM) over the same time period. GSM represented 2.2% of the 16,388 patients identified with either GSM or GBM. No significant differences between GSM and GBM were identified with respect to age, gender, race, tumor size, or use of adjuvant radiation therapy (RT). Patients with GSM were more likely to have temporal lobe involvement and undergo some form of tumor resection. The most important analyzed factors influencing GSM overall survival were age, extent of resection, and use of adjuvant RT. After adjusting for factors impacting overall survival, the prognosis for GSM appears slightly worse than for GBM (HR = 1.17, 95% CI, 1.05-1.31). GSM is a rare malignancy that presents very similarly to GBM with a slightly greater propensity for temporal lobe involvement. Optimal treatment remains to be defined. However, these retrospective findings suggest tumor excision, as opposed to biopsy only, and adjuvant RT may improve outcome. Despite therapy, prognosis remains dismal and outcomes may be inferior to those seen in GBM patients.
Kozak
Kevin R
KR
Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA. kozak@humonc.wisc.edu
Mahadevan
Anand
A
Moody
John S
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy; D005260:Female; D018316:Gliosarcoma / Q000453:epidemiology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D018426:SEER Program; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
J Neurooncol. 2005 Aug;74(1):59-63
16078109
AJNR Am J Neuroradiol. 1987 Jan-Feb;8(1):117-22
3101453
Cancer. 1995 Jun 15;75(12):2910-8
7773942
Clin Neurol Neurosurg. 2006 Feb;108(2):178-86
16412839
J Neurosurg. 1993 May;78(5):767-75
8468607
J Neurosurg. 1998 Sep;89(3):425-30
9724117
Radiother Oncol. 2001 Oct;61(1):57-64
11578729
Pediatr Neurosurg. 1993 Mar-Apr;19(2):57-62
8443097
Br J Neurosurg. 1995 Apr;9(2):171-8
7632363
Acta Oncol. 2007;46(8):1202-4
17851847
N Engl J Med. 2005 Mar 10;352(10):987-96
15758009
J Natl Cancer Inst. 1993 May 5;85(9):704-10
8478956
J Neurosurg. 1976 Oct;45(4):398-408
956876
J Neurosurg. 2003 Sep;99(3):467-73
12959431
Am J Pathol. 1955 Jul-Aug;31(4):633-53
14388124
Cancer. 1991 May 1;67(9):2342-9
1849447
Clin Neurol Neurosurg. 1998 Jun;100(2):153-9
9746306
Indian J Med Res. 1997 Sep;106:229-35
9378529
J Neuropathol Exp Neurol. 1978 May;37(3):300-13
660217
Neurosurgery. 1991 Sep;29(3):385-8; discussion 388-9
1833663