Choi Seo Hee, Kim Se Hoon, Shim Kyu-Won, Han Jung Woo, Choi Junjeong, Kim Dong-Seok, Lyu Chuhl Joo, Kim Jun Won, Suh Chang-Ok, Cho Jaeho
Departments of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
Departments of Pathology, Yonsei University College of Medicine, Seoul, Korea.
PLoS One. 2016 Apr 13;11(4):e0153443. doi: 10.1371/journal.pone.0153443. eCollection 2016.
To identify prognostic factors and define the optimal management of patients with supratentorial primitive neuroectodermal tumors (sPNETs), we investigated treatment outcomes and explored the prognostic value of specific molecular markers.
A total of 47 consecutive patients with pathologically confirmed sPNETs between May 1985 and June 2012 were included. Immunohistochemical analysis of LIN28, OLIG2, and Rad51 expression was performed and correlated with clinical outcome.
With a median follow-up of 70 months, 5-year overall survival (OS) and progression-free survival (PFS) was 55.5% and 40%, respectively, for all patients. Age, surgical extent, and radiotherapy were significant prognostic factors for OS and PFS. Patients who received initially planned multimodal treatment without interruption (i.e., radiotherapy and surgery (≥subtotal resection), with or without chemotherapy) showed significantly higher 5-year OS (71.2%) and PFS (63.1%). In 29 patients with available tumor specimens, tumors with high expression of either LIN28 or OLIG2 or elevated level of Rad51 were significantly associated with poorer prognosis.
We found that multimodal treatment improved outcomes for sPNET patients, especially when radiotherapy and ≥subtotal resection were part of the treatment regimen. Furthermore, we confirmed the prognostic significance of LIN28 and OLIG2 and revealed the potential role of Rad51 in sPNETs.
为了确定幕上原始神经外胚层肿瘤（sPNETs）患者的预后因素并明确最佳治疗方案，我们调查了治疗结果并探讨了特定分子标志物的预后价值。
纳入了1985年5月至2012年6月期间连续的47例经病理证实的sPNETs患者。对LIN28、OLIG2和Rad51表达进行免疫组织化学分析，并与临床结果相关联。
所有患者的中位随访时间为70个月，5年总生存率（OS）和无进展生存率（PFS）分别为55.5%和40%。年龄、手术范围和放疗是OS和PFS的重要预后因素。最初接受计划好的多模式治疗且未中断的患者（即放疗和手术（≥次全切除），有或无化疗）显示5年OS（71.2%）和PFS（63.1%）显著更高。在29例有可用肿瘤标本的患者中，LIN28或OLIG2高表达或Rad51水平升高的肿瘤与较差的预后显著相关。
我们发现多模式治疗改善了sPNET患者的预后，特别是当放疗和≥次全切除是治疗方案的一部分时。此外，我们证实了LIN28和OLIG2的预后意义，并揭示了Rad51在sPNETs中的潜在作用。
