title: Management and Survival Patterns of Patients with Gliomatosis Cerebri: A SEER-Based Analysis.
abstract: OBJECTIVE
  We used the SEER (Surveillance Epidemiology and End Results) database (1999-2010) to analyze the clinical practice patterns and overall survival in patients with gliomatosis cerebri (GC), or glioma involving 3 or more lobes of the cerebrum.
  
  
  METHODS
  We identified 111 patients (age ≥18 years) with clinically or microscopically diagnosed GC in the SEER database. Analyses were performed to determine clinical practice patterns for these patients and whether these practices were associated with survival.
  
  
  RESULTS
  Fifty-eight percent of the 111 patients with GC received microscopic confirmation of their diagnosis. Of the remaining patients, 40% were diagnosed via imaging or laboratory tests, and 2% had unknown methods of diagnosis. Seven percent of patients who did not have microscopic confirmation of their diagnosis received radiation therapy. Radiation therapy and surgery were not associated with survival. The only variable significantly associated with overall survival was age at diagnosis. Patients aged 18-50 years showed improved survival relative to patients aged >50 years (median survival, 11 and 6 months, respectively; P = 0.03). For patients aged >50 years, improved overall survival was observed in the post-temozolomide era (2005-2010) relative to those treated in the pre-temozolomide era (1999-2004) (median survival, 9 and 4 months, respectively; P = 0.005).
  
  
  CONCLUSIONS
  In the SEER database, ∼40% of the patients with glioma with imaging findings of GC do not receive microscopic confirmation of their diagnosis. We propose that tissue confirmation is warranted in patients with GC, because genomic analysis of these specimens may provide insights that will contribute to meaningful therapeutic intervention.
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Kate T
authors.initials: KT
authors.lastname: Carroll
authors.affiliation: Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Hirshman
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Mir Amaan
authors.initials: MA
authors.lastname: Ali
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Alattar
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Brandel
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Bryson
authors.initials: B
authors.lastname: Lochte
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Lanman
authors.affiliation: Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA.
authors.forename: Bob
authors.initials: B
authors.lastname: Carter
authors.affiliation: Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA. Electronic address: clarkchen@ucsd.edu.
authors.forename: Clark C
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001254:Astrocytoma / Q000401:mortality / Q000628:therapy*; D001932:Brain Neoplasms / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019468:Disease Management; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000628:therapy*; D005910:Glioma / Q000401:mortality / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000628:therapy*; D018302:Neoplasms, Neuroepithelial / Q000401:mortality / Q000628:therapy; D019635:Neurosurgical Procedures; D009837:Oligodendroglioma / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018426:SEER Program; D015996:Survival Rate; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: Gliomatosis cerebri; Overall survival; SEER