Document Detail


Gliomatosis cerebri: clinical characteristics, management, and outcomes.
MedLine Citation:
PMID:  23341100     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Gliomatosis cerebri is a rare diffusely infiltrating primary neoplastic glial process of the brain. Our objective is to review clinical presentation, management, and outcome in a large single institution series of gliomatosis cerebri patients. 54 consecutive gliomatosis cerebri cases presenting to Mayo Clinic Rochester between 1991 and 2008 were retrospectively reviewed. Inclusion criteria included involvement of at least three cerebral lobes, lack of a single discrete mass and pathological confirmation of diffuse glioma. Median overall survival (OS) was 18.5 months. Age, gender, presenting symptoms, and contrast enhancement did not correlate significantly with survival, though there was a trend toward decreased overall survival in patients above the median age of 46 years. Karnofsky performance score <70 was associated with poor OS (median 9.5 vs. 20.5 months, p = 0.02). Higher histologic grade was associated with poor progression-free survival (PFS; median for WHO grades II, III, and IV: 21.5, 6.5, and 4 months; p = 0.03) and OS (median 34, 15.5, and 8.5 months; p < 0.05). Radiation therapy was strongly associated with better prognosis (PFS 16.5 vs. 4.5 months, p < 0.01; OS 27.5 vs. 6.5, p < 0.01), but chemotherapy was not. Gliomatosis cerebri patients have a poor prognosis. Lower KPS upon presentation and higher histologic grade predict decreased survival. Surgery's role is limited beyond biopsy for diagnostic purposes. Radiotherapy appears beneficial, although selection bias could be present in this retrospective study. Chemotherapy's value is not as clear but this must be interpreted with caution given variable treatment regimens in this series.
Authors:
Selby Chen; Shota Tanaka; Caterina Giannini; Jonathan Morris; Elizabeth S Yan; Jan Buckner; Daniel H Lachance; Ian F Parney
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural     Date:  2013-01-23
Journal Detail:
Title:  Journal of neuro-oncology     Volume:  112     ISSN:  1573-7373     ISO Abbreviation:  J. Neurooncol.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-26     Completed Date:  2013-09-10     Revised Date:  2014-02-03    
Medline Journal Info:
Nlm Unique ID:  8309335     Medline TA:  J Neurooncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  267-75     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Brain Neoplasms / mortality*,  pathology,  therapy
Child
Combined Modality Therapy
Disease Progression
Female
Follow-Up Studies
Humans
Immunoenzyme Techniques
Male
Middle Aged
Neoplasm Grading
Neoplasm Recurrence, Local / mortality*,  pathology,  therapy
Neoplasms, Neuroepithelial / mortality*,  pathology,  therapy
Prognosis
Retrospective Studies
Survival Rate
Young Adult
Grant Support
ID/Acronym/Agency:
1P50CA108961-06/CA/NCI NIH HHS; P50 CA108961/CA/NCI NIH HHS
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