Malignant brainstem gliomas in adults: Clinicopathological characteristics and prognostic factors

Ranjith Babu, Peter G. Kranz, Vijay Agarwal, Roger E. McLendon, Steven Thomas, Allan H. Friedman, Darell D. Bigner, Cory Adamson

Research output: Contribution to journalArticle

Abstract

Adult malignant brainstem gliomas (BSGs) are poorly characterized due to their relative rarity. We have examined histopathologically confirmed cases of adult malignant BSGs to better characterize the patient and tumor features and outcomes, including the natural history, presentation, imaging, molecular characteristics, prognostic factors, and appropriate treatments. A total of 34 patients were identified, consisting of 22 anaplastic astrocytomas (AAs) and 12 glioblastomas (GBMs). The overall median survival for all patients was 25.8 months, with patients having GBMs experiencing significantly worse survival (12.1 vs. 77.0 months, p = 0.0011). The majority of tumors revealed immunoreactivity for EGFR (93.3 %) and MGMT (64.7 %). Most tumors also exhibited chromosomal abnormalities affecting the loci of epidermal growth factor receptor (92.9 %), MET (100 %), PTEN (61.5 %), and 9p21 (80 %). AAs more commonly appeared diffusely enhancing (50.0 vs. 27.3 %) or diffusely nonenhancing (25.0 vs. 0.0 %), while GBMs were more likely to exhibit focal enhancement (54.6 vs. 10.0 %). Multivariate analysis revealed confirmed histopathology for GBM to significantly affect survival (HR 4.80; 95 % CI 1.86-12.4; p = 0.0012). In conclusion, adult malignant BSGs have an overall poor prognosis, with GBM tumors faring significantly worse than AAs. As AAs and GBMs have differing imaging characteristics, tissue diagnosis may be necessary to accurately determine patient prognosis and identify molecular characteristics which may aid in the treatment of these aggressive tumors.

Original languageEnglish (US)
Pages (from-to)177-185
Number of pages9
JournalJournal of Neuro-Oncology
Volume119
Issue number1
DOIs
StatePublished - Aug 2014
Externally publishedYes

Fingerprint

Brain Stem Neoplasms
Glioblastoma
Tumor Biomarkers
Glioma
Brain Stem
Young Adult
Astrocytoma
Neoplasms
Survival
Molecular Imaging
Natural History
Epidermal Growth Factor Receptor
Chromosome Aberrations
Multivariate Analysis
Therapeutics

Keywords

  • Adult
  • Brainstem glioma
  • Clinicopathological
  • Molecular
  • Treatment

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Malignant brainstem gliomas in adults : Clinicopathological characteristics and prognostic factors. / Babu, Ranjith; Kranz, Peter G.; Agarwal, Vijay; McLendon, Roger E.; Thomas, Steven; Friedman, Allan H.; Bigner, Darell D.; Adamson, Cory.

In: Journal of Neuro-Oncology, Vol. 119, No. 1, 08.2014, p. 177-185.

Research output: Contribution to journalArticle

Babu, R, Kranz, PG, Agarwal, V, McLendon, RE, Thomas, S, Friedman, AH, Bigner, DD & Adamson, C 2014, 'Malignant brainstem gliomas in adults: Clinicopathological characteristics and prognostic factors', Journal of Neuro-Oncology, vol. 119, no. 1, pp. 177-185. https://doi.org/10.1007/s11060-014-1471-9
Babu, Ranjith ; Kranz, Peter G. ; Agarwal, Vijay ; McLendon, Roger E. ; Thomas, Steven ; Friedman, Allan H. ; Bigner, Darell D. ; Adamson, Cory. / Malignant brainstem gliomas in adults : Clinicopathological characteristics and prognostic factors. In: Journal of Neuro-Oncology. 2014 ; Vol. 119, No. 1. pp. 177-185.
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