Prognostic factors and clinical outcomes in adult primary gliosarcoma patients: a Surveillance, Epidemiology, and End Results (SEER) analysis from 2004 to 2015
Prognostic factors and clinical outcomes in adult primary gliosarcoma patients: a Surveillance, Epidemiology, and End Results (SEER) analysis from 2004 to 2015
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成人原发性胶质肉瘤患者的预后因素和临床结果：2004 年至 2015 年的监测、流行病学和最终结果 (SEER) 分析。
DOI：
10.1080/02688697.2019.1699903
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发表时间：
2019-12-11
影响因子：
1.1
通讯作者：
Chen, Juxiang
中科院分区：
文献类型：
--
作者：
Huang, Qilin;Li, Feng;Chen, Juxiang
目的：胶质肉瘤（GSC）是一种罕见的恶性脑肿瘤，被认为是异柠檬酸脱氢酶1野生型（IDH 1-WT）胶质母细胞瘤（GBM）的变体。本研究旨在通过监测、流行病学和最终结果（SEER）数据库，回顾性分析GSC的临床特征，比较GSC和GBM患者的治疗策略和结局是否存在差异。患者和方法：从SEER数据库中查询2004年至2015年诊断为原发性GSC的成人临床数据。采用Kaplan-Meier曲线和考克斯模型分析各临床参数与患者预后的关系。对SEER的所有原发性GBM患者进行了类似的分析。结果：共有527例GSC和20，541例GBM患者最终入选进行进一步分析，这些患者具有完整有效的临床信息。与GBM相比，GSC更倾向于颞叶而不是额叶（p < 0.001），保守性更低（p < 0.001），对放射治疗的敏感性更高（p < 0.001）。单因素分析显示，手术、放疗和化疗均能延长GSC患者的总生存期，但无论是否联合放化疗，EOR对患者的预后均无优势。多因素分析显示，年龄> 60岁和未行放化疗是影响GSC患者OS的独立危险因素。结论：我们的研究发现，虽然EOR似乎对GBM很重要，但手术范围与GSC预后改善并没有明显关系。放疗和化疗可明显延长患者的生存期，对GSC的治疗有更积极的作用，有待进一步研究。
Objective: Gliosarcoma (GSC), a rare malignant brain tumor, is considered as a variant of isocitrate dehydrogenase 1 wild type (IDH1-WT) glioblastoma (GBM). This study aimed to retrospectively analyze the clinical characteristics of GSC and compare whether there are some differences of treatment strategies and outcomes between GSC and GBM patients through Surveillance, Epidemiology, and End Results (SEER) database. Patients and methods: The clinical data of adults diagnosed with primary GSC between 2004 and 2015 were queried from SEER database. The Kaplan-Meier curve and the Cox model were performed to analyze the relationships between clinical parameters and patients' prognosis. Similar analyses were conducted for all primary GBM patients of SEER. Results: In total, 527 GSC and 20,541 GBM patients with complete and valid clinical information were finally enrolled for further analysis. Compared with GBM, GSC owned a proclivity to temporal lobe rather than frontal lobe (p < 0.001), a less conservative extension of resection (EOR) (p < 0.001), and a higher sensitivity to radiotherapy (p < 0.001). As shown by univariate analysis, surgery, radiotherapy and chemotherapy could prolong the overall survival (OS) time of GSC, but EOR did not confer an advantage to the outcomes of patients, no matter whether combined radio/chemotherapy was given. In multivariate analysis, age more than 60 and lack of radio/chemotherapy were identified as independent risk factors for OS of GSC patients. Conclusions: Our study found that although EOR seemed to be important to GBM, the extent of surgery did not show a clear relationship with the improved prognosis of GSC. Additionally, radiotherapy and chemotherapy could prolong patients' survival time significantly, which suggests a more positive role of them in treating GSC and needs further investigations.