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KMID : 0942820120110020083
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Journal of Korean Brain Tumor Society
2012 Volume.11 No. 2 p.83 ~ p.87
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Clinical Outcome of Primary Gliosarcoma : A Single Institutional Series
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Byun Joon-Ho
Yun Jung-Ho
Cho Young-Hyun
Kim Jeong-Hoon
Kim Chang-Jin
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Abstract
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Objectives: Primary gliosarcoma (GSM) is a rare central nervous system tumor with few reports described in the literature. Here, we present our clinical experience and the outcome of primary GSM patients in a single medical center.
Method: Primary GSM patients who were treated at our institution between 1990 and 2011 were selected retrospectively. All patients were analyzed by meticulous chart review including clinical and pathologic data. Overall survival was analyzed by Kaplan-Meier survival analysis.
Results: Eleven patients were diagnosed with primary GSM. It was 1.7% of glioblastoma (GBM) during the same period. The overall median survival of the 11 patients was 12 months (range : 3 to 177 months). Patients who underwent maximal safe resection had a prolonged median survival compared to those who only underwent biopsy of the tumor (12 vs. 6 months, p=0.288). All patients received adjuvant postoperative radiotherapy and 7 of 11 patients received chemotherapy with temozolomide. Four patients received gamma-knife radiosurgery for local recurrence; however, treatment method by gamma-knife radiosurgery was not significantly associated with prolonged survival in this study. Patients who received re-explorative surgery for resectable recurred tumors had a prolonged median survival compared to those who had non-resectable recurred tumors (14 vs. 6 months, p=0.0082).
Conclusion: ：We present 11 primary GSM patients who were treated according to the standard treatment for GBM. Despite aggressive multimodality treatment, the life expectancy of GSM is very short until now. Therefore, large and comprehensive clinical investigations are needed to establish the standard treatment for primary GSM.
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KEYWORD
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Primary gliosarcoma, Gamma-knife radiosurgery, Re-explorative surgery, Temozolomide
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