title: Poor prognosis despite aggressive treatment in adults with intramedullary spinal cord glioblastoma.
abstract: We report our institution's experience with adult patients who underwent surgery for intramedullary spinal cord glioblastoma. Spine involvement of glioblastoma is rare, representing 7.5% of all intramedullary gliomas and 1-3% of all spinal cord tumors. We performed a retrospective review of five male patients with intramedullary spinal cord glioblastoma who underwent surgical resection from 1990 to 2014. Demographic, operative, and postoperative factors were recorded. The median age at treatment was 31 years (range: 18-61) and all men presented with motor or sensory dysfunction. Two had prior surgical resection of an intramedullary World Health Organization Grade III anaplastic astrocytoma lesion with adjuvant chemoradiation. All tumors were present in the cervical (n=2; 40%) or thoracic (n=3; 60%) spine, spanning a median of three levels (range: 2-4). Gross total resection was achieved in three men (60%), and there were no intraoperative mortalities or complications. Although one had improvement in his neurological status postoperatively, all five men died with a median time to death of 20 months (range: 2-31). Adult intramedullary spinal cord glioblastoma is rare, and despite aggressive treatment, prognosis is poor, with a median survival in our series of only 20 months. New treatment strategies are necessary to improve survival in this patient population.
authors.affiliation: Department of Neurosurgery, Johns Hopkins Hospital, Phipps, Room 118, 600 North Wolfe Street, Baltimore, MD 21287, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Johns Hopkins Hospital, Phipps, Room 118, 600 North Wolfe Street, Baltimore, MD 21287, USA.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Sankey
authors.affiliation: Department of Neurosurgery, Johns Hopkins Hospital, Phipps, Room 118, 600 North Wolfe Street, Baltimore, MD 21287, USA. Electronic address: cbetteg1@jhmi.edu.
authors.forename: Chetan
authors.initials: C
authors.lastname: Bettegowda
authors.affiliation: Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Burger
authors.affiliation: Department of Neurosurgery, Johns Hopkins Hospital, Phipps, Room 118, 600 North Wolfe Street, Baltimore, MD 21287, USA.
authors.forename: George I
authors.initials: GI
authors.lastname: Jallo
authors.affiliation: Department of Neurosurgery, Johns Hopkins Hospital, Phipps, Room 118, 600 North Wolfe Street, Baltimore, MD 21287, USA.
authors.forename: Mari L
authors.initials: ML
authors.lastname: Groves
mesh_terms: D000328:Adult; D001254:Astrocytoma / Q000601:surgery; D002574:Cervical Vertebrae; D005909:Glioblastoma / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011379:Prognosis; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome
keywords: Adult; Glioblastoma; Intramedullary; Oncology; Spine