Liu Jinghui, Li Chen, Wang Yuan, Ji Peigang, Guo Shaochun, Zhai Yulong, Wang Na, Xu Meng, Wang Julei, Wang Liang
Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China.
Front Oncol. 2023 Jan 31;12:1026747. doi: 10.3389/fonc.2022.1026747. eCollection 2022.
Secondary gliosarcomas (SGS) are rare malignancies that are diagnosed subsequent to pre-existing glioma. Clinical features and optimal treatment strategies for SGS have not been conclusively established. This study aimed to assess the clinicopathological features and outcomes of SGS.
We assessed the clinicopathological features and outcomes of SGS via retrospective analysis of data for SGS patients at Tangdu Hospital. Data from SGS patients in prior publications were also analyzed in accordance with PRISMA guidelines.
Eighteen SGS patients who had been treated at Tangdu Hospital between 2013 and 2020 were enrolled in this study. Additional 89 eligible SGS patients were identified from 39 studies. The median age for the patients was 53 years old, and the most common location was the temporal lobe. The most common initial diagnosis was glioblastoma (GBM) (72.0%). Radiology revealed enhanced masses in 94.8% (73/77) of patients. Ten patients (10/107, 9.35%) had extracranial metastases at or after SGS diagnosis. Patients with initial diagnosis of non-GBM and who were younger than 60 years of age were significantly associated with a long duration of disease progression to SGS. After SGS diagnosis, patients with initial non-GBM diagnosis, gross total resection and chemoradiotherapy exhibited prolonged survival outcomes. Patients who had been initially diagnosed with GBM and received both chemoradiotherapy and active therapy after disease progression to SGS, had a significantly longer overall survival than patients who did not.
Initial diagnosis of GBM was a poor prognostic factor for SGS. Patients who underwent gross total resection and chemoradiation had better overall survival outcomes than those who did not. However, during treatment, clinicians should be cognizant of possible extracranial metastases.
继发性胶质肉瘤（SGS）是一种罕见的恶性肿瘤，在先前存在的胶质瘤之后被诊断出来。SGS的临床特征和最佳治疗策略尚未最终确定。本研究旨在评估SGS的临床病理特征和预后。
我们通过回顾性分析唐都医院SGS患者的数据来评估SGS的临床病理特征和预后。还根据PRISMA指南分析了先前出版物中SGS患者的数据。
本研究纳入了2013年至2020年期间在唐都医院接受治疗的18例SGS患者。从39项研究中又确定了89例符合条件的SGS患者。患者的中位年龄为53岁，最常见的部位是颞叶。最常见的初始诊断是胶质母细胞瘤（GBM）（72.0%）。放射学检查显示94.8%（73/77）的患者有强化肿块。10例患者（10/107，9.35%）在SGS诊断时或之后发生颅外转移。初始诊断为非GBM且年龄小于60岁的患者与SGS疾病进展持续时间长显著相关。SGS诊断后，初始诊断为非GBM、接受全切除和放化疗的患者生存时间延长。初始诊断为GBM且在疾病进展为SGS后接受放化疗和积极治疗的患者，其总生存期明显长于未接受治疗的患者。
GBM的初始诊断是SGS的不良预后因素。接受全切除和放化疗的患者总体生存结果优于未接受者。然而，在治疗过程中，临床医生应注意可能发生的颅外转移。
