Prognostic and predictive factors of secondary gliosarcoma: A single-institution series of 18 cases combined with 89 cases from literature

Jinghui Liu; Chen Li; Yuan Wang; Peigang Ji; Shaochun Guo; Yulong Zhai; Na Wang; Meng Xu; Julei Wang; Liang Wang

doi:10.3389/fonc.2022.1026747

Prognostic and predictive factors of secondary gliosarcoma: A single-institution series of 18 cases combined with 89 cases from literature

Front Oncol. 2023 Jan 31:12:1026747. doi: 10.3389/fonc.2022.1026747. eCollection 2022.

Authors

Jinghui Liu¹, Chen Li¹, Yuan Wang¹, Peigang Ji¹, Shaochun Guo¹, Yulong Zhai¹, Na Wang¹, Meng Xu², Julei Wang¹, Liang Wang^{1

3}

Affiliations

¹ Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
² Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China.
³ Innovation Center for Advanced Medicine, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: chemoradiation; extracranial metastasis; glioblastoma; prognosis; secondary gliosarcoma.

Grants and funding

This work was supported by the National Natural Science Foundation of China (81772661), the Natural Science Foundation of Shaanxi Province (2020JZ-30).