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Multicenter Study
. 2021 May;42(5):1879-1886.
doi: 10.1007/s10072-020-04725-7. Epub 2020 Sep 21.

Adult brainstem glioma: a multicentre retrospective analysis of 47 Italian patients

Andrea Rigamonti  1 , Giorgia Simonetti  2 , Antonio Silvani  2 , Roberta Rudà  3 , Federica Franchino  3 , Veronica Villani  4 , Andrea Pace  4 , Rossella Merli  5 , Maura Servida  6 , Alberto Picca  7 , Giulia Berzero  7 , Alfonso Cerase  8 , Ivano Chiarotti  8 , Giannantonio Spena  9 , Andrea Salmaggi  9 ; neurooncology group of SNO (Society of Hospital Neurosciences, Italy)
Affiliations
Multicenter Study

Adult brainstem glioma: a multicentre retrospective analysis of 47 Italian patients

Andrea Rigamonti et al. Neurol Sci. 2021 May.

Abstract

Background and purpose: Adult brainstem gliomas are rare primary brain tumours with heterogeneous clinical course. The low frequency of these tumours makes it difficult to achieve high-quality evidence regarding prognostic factors, adequate therapeutic approach and outcome in such patients.

Methods: In this retrospective study, we analysed clinical, radiological, molecular, prognostic and therapeutic factors in a series of 47 histologically proven adult brainstem gliomas recruited over a 20-year period (1998-2018).

Results: Twenty-two patients were male, 25 female with median age of 39 years. The tumour involved one brainstem segment in 20 cases and 2 or more segments in 27. Contrast enhancement was reported in 28 cases. Surgical procedures included biopsy in 26 cases and partial/total resection in the remaining 21. Histological diagnosis was of low-grade glioma in 23 patients, high-grade glioma in 22 and non-diagnostic in 2 cases. Data regarding molecular biology were available for 22 patients. Median overall survival was 35 months, in particular 16 months in high-grade glioma and 84 months in low-grade glioma. At univariate analysis, tumour grade was the only factor with a statistically significant impact on survival time (p = 0,003), whereas younger age, better performance status and total/subtotal resection showed a trend to more prolonged survival. This study also confirms safety of biopsy/surgery in adult brainstem glioma patients and shows a clear trend to a more frequent assessment of molecular biology data.

Conclusions: Further prospective multicentre efforts, and hopefully clinical trials, are necessary to improve outcome in this neglected glioma patient population.

Keywords: Adult; Brainstem gliomas; Management; Prognosis; Survival.

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