Department of Neurosurgery, Hannover Medical School, Hannover, Germany.
Department of Neurosurgery, Brandenburg Medical School, Helios Medical Center, Bad Saarow, Germany.
Br J Neurosurg. 2024 Apr;38(2):332-339. doi: 10.1080/02688697.2021.1872773. Epub 2021 Feb 4.
There are only few studies comparing differences in the outcome of primary versus secondary gliosarcoma. This study aimed to review the outcome and survival of patients with primary or secondary gliosarcoma following surgical resection and adjuvant treatment. The data were also matched with data of patients with primary and secondary glioblastoma (GBM).
Treatment histories of 10 patients with primary gliosarcoma and 10 patients with secondary gliosarcoma were analysed and compared. Additionally, data of 20 patients with primary and 20 patients with secondary GBM were analysed and compared. All patients underwent surgical resection of the tumour in our department. Follow-up data, progression-free survival (PFS), and median overall survival (mOS) were evaluated.
The median PFS in patients with primary gliosarcoma was significantly higher than in patients with secondary gliosarcoma ( = 0.037). The 6-month PFS rates were 80.0% in patients with primary and 30.0% in patients with secondary gliosarcoma. Upon recurrence, five patients with primary gliosarcoma and four patients with secondary gliosarcoma underwent repeat surgical resection. The mOS of patients with primary gliosarcoma was significantly higher than that of patients with secondary gliosarcoma ( = 0.031). The percentage of patients surviving at 1-year/2-year follow-up in primary gliosarcoma was 70%/20%, while it was only 10%/10% in secondary gliosarcoma. When PFS and mOS of primary gliosarcoma was compared to primary GBM, there were no statistically differences ( = 0.509; = 0.435). The PFS and mOS of secondary gliosarcoma and secondary GBM were also comparable ( = 0.290 and = 0.390).
Patients with primary gliosarcoma have a higher PFS and mOS compared to those with secondary gliosarcoma. In the case of tumour recurrence, patients with secondary gliosarcoma harbour an unfavourable prognosis with limited further options. The outcome of patients with primary or secondary gliosarcoma is comparable to that of patients with primary or secondary GBM.
仅有少数研究比较了原发性与继发性胶质肉瘤的结果差异。本研究旨在回顾行手术切除和辅助治疗后原发性或继发性胶质肉瘤患者的结局和生存情况。数据还与原发性和继发性胶质母细胞瘤（GBM）患者的数据进行了匹配。
分析并比较了 10 例原发性胶质肉瘤患者和 10 例继发性胶质肉瘤患者的治疗史。此外，还分析并比较了 20 例原发性和 20 例继发性 GBM 患者的数据。所有患者均在我科行肿瘤切除术。评估了随访数据、无进展生存期（PFS）和中位总生存期（mOS）。
原发性胶质肉瘤患者的中位 PFS 明显高于继发性胶质肉瘤患者（=0.037）。6 个月时 PFS 率分别为原发性胶质肉瘤患者的 80.0%和继发性胶质肉瘤患者的 30.0%。在复发时，5 例原发性胶质肉瘤患者和 4 例继发性胶质肉瘤患者再次行手术切除。原发性胶质肉瘤患者的 mOS 明显高于继发性胶质肉瘤患者（=0.031）。1 年和 2 年随访时原发性胶质肉瘤患者的生存率分别为 70%/20%，而继发性胶质肉瘤患者的生存率仅为 10%/10%。原发性胶质肉瘤的 PFS 和 mOS 与原发性 GBM 比较，差异无统计学意义（=0.509；=0.435）。继发性胶质肉瘤和继发性 GBM 的 PFS 和 mOS 也相当（=0.290 和=0.390）。
与继发性胶质肉瘤患者相比，原发性胶质肉瘤患者的 PFS 和 mOS 更高。在肿瘤复发的情况下，继发性胶质肉瘤患者的预后较差，进一步治疗选择有限。原发性或继发性胶质肉瘤患者的结局与原发性或继发性 GBM 患者的结局相当。
