title: Primary Spinal Cord Glioblastoma Multiforme: A Retrospective Study of Patients at a Single Institution.
abstract: OBJECTIVE
  Primary spinal cord (PSC) glioblastoma multiforme (GBM) is extremely rare and accounts for only 1.5% of all spinal cord tumors. Therefore, its treatment is still ill defined. To elucidate prognostic factors, we performed a single-institutional retrospective review of the largest series to date of patients with PSC GBM who underwent surgical resection in West China Hospital between 2008 and 2014. A total of 14 patients with PSC GBM were reviewed.
  
  
  METHODS
  Demographic, operative, and postoperative factors were recorded. Overall survival (OS) and progression-free survival (PFS) were calculated and compared with the Kaplan-Meier method.
  
  
  RESULTS
  Eight males (57%) and 6 females (43%) were involved in the study. Their median age was 28 years (range, 14-56 years). Median Karnofsky Performance Status score was 60 (range, 20-90). Four patients (28.6%) received gross total resection, 5 (35.7%) partial resection, and the remaining 5 (35.7%) biopsy only. Nine patients (64.3%) received postoperative radiotherapy and chemotherapy, 3 (21.4%) chemotherapy only, and 2 (14.3%) neither. Median follow-up period was 15 months (range, 5-26 months). One-year and 2-year survival was 78.5% (11/14) and 7.1% (1/14), respectively. Median OS was 15 months, and median PFS 8 months. Univariate log-rank analysis showed that OS and PFS were significantly associated with patients' age (P = 0.007 and P = 0.04, respectively) and postoperative radiotherapy (P = 0.001 and P = 0.002, respectively). However, preoperative Karnofsky Performance Status score affected only OS and did not affect PFS (P = 0.033 and P = 0.106, respectively).
  
  
  CONCLUSIONS
  According to our study, the combination of postoperative radiotherapy and temozolomide chemotherapy can improve prognosis and may serve as a feasible postoperative adjuvant treatment of PSC GBM.
authors.affiliation: Department of Neurosurgery, Chongqing Cancer Hospital, Chongqing, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Neurosurgery, Chongqing Cancer Hospital, Chongqing, China.
authors.forename: Silong
authors.initials: S
authors.lastname: Lou
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Siqing
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: 10991391@qq.com.
authors.forename: Jiagang
authors.initials: J
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D017567:Karnofsky Performance Status; D007796:Laminectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D000077204:Temozolomide; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: Glioblastoma; Radiotherapy; Spinal cord; Surgery