Abstract
Purpose
To analyze the outcomes and predictors in a large series of cerebellar glioblastomas in order to guide patient management.
Methods
The French brain tumor database and the Club de Neuro-Oncologie of the Société Française de Neurochirurgie retrospectively identified adult patients with cerebellar glioblastoma diagnosed between 2003 and 2017. Diagnosis was confirmed by a centralized neuropathological review.
Results
Data from 118 cerebellar glioblastoma patients were analyzed (mean age 55.9 years, 55.1% males). The clinical presentation associated raised intracranial pressure (50.8%), static cerebellar syndrome (68.6%), kinetic cerebellar syndrome (49.2%) and/or cranial nerve disorders (17.8%). Glioblastomas were hemispheric (55.9%), vermian (14.4%) or both (29.7%). Hydrocephalus was present in 49 patients (41.5%). Histologically, tumors corresponded either to IDH-wild-type or to K27-mutant glioblastomas.
Surgery consisted of total (12.7%), subtotal (35.6%), partial resection (33.9%) or biopsy (17.8%). The postoperative Karnofsky performance status was improved, stable and worsened in 22.4%, 43.9% and 33.7% of patients, respectively. Progression-free and overall survivals reached 5.1 months and 9.1 months, respectively.
Compared to other surgical strategies, total or subtotal resection improved the Karnofsky performance status (33.3% vs 12.5%, p < 0.001), prolonged progression-free and overall survivals (6.5 vs 4.3 months, p = 0.015 and 16.7 vs 6.2 months, p < 0.001, respectively) and had a comparable complication rate (40.4% vs 31.1%, p = 0.29). After total or subtotal resection, the functional outcomes were correlated with age (p = 0.004) and cerebellar hemispheric tumor location (p < 0.001) but not brainstem infiltration (p = 0.16).
Conclusion
In selected patients, maximal resection of cerebellar glioblastoma is associated with improved onco-functional outcomes, compared with less invasive procedures.
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Anonymized data will be shared by request from any qualified investigator.
Abbreviations
- cGB:
-
Cerebellar glioblastoma
- CNO-SFNC:
-
Club of Neuro-Oncologie of the Société Française de Neurochirurgie
- FBTDB:
-
French brain tumor database
- GB:
-
Glioblastoma
- KPS:
-
Karnofsky Performance Status
- OS:
-
Overall Survival
- PFS:
-
Progression-free survival
- stGB:
-
Supratentorial glioblastoma
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Acknowledgements
French Brain Tumor DataBase: Fabienne Bauchet (FBTDB, ICM Montpellier), Rim Ben Mhamed (CHU Montpellier), Faiza Bessaoud (Registre Tumeur Hérault, Montpellier), Valérie Rigau (CHU Montpellier), Hélène Mathieu-Daudé (ICM Montpellier), Amélie Darlix (ICM Montpellier), Pascale Fabbro-Peray (CHU Nîmes), Brigitte Trétarre (Registre Tumeur Hérault, Montpellier). Club de Neuro-Oncologie of the Société Française de Neurochirurgie: Hugues Loiseau (CHU Bordeaux), Jean-Rodolphe Vignes (CHU Bordeaux), Mathilde Guibourd de Luzinais (CHU Bordeaux), Matthieu Peyre (APHP – Hôpital La Pitié Salpêtrière), Eric Bord (CHU Nantes), Edouard Samarut (CHU Nantes), Romuald Seizeur (CHU Brest), Walid Farah (CHU Dijon), Anne Herbrecht (APHP – Kremlin Bicêtre), Nicolas Reyns (CHU Lille), Jimmy Voirin (CH Colmar), Hélène Cebula (CHU Strasbourg), Evelyne Emery (CHU Caen), Adrien Simonneau (Fondation-Ophtalmologique Rothschild), Philippe Caillaud (CHU Bayonne), Philippe Menei (CHU Angers), Gwénaëlle Soulard (CHU Angers), Bertrand Muckensturm (CH Orléans), Fabien Rech (CHU Nancy), Fabien Almairac (CHU Nice), Marie Onno (CHU Nice), Marine Lecorre (CHU Montpellier), Arnaud Dagain (HIA Sainte-Anne—Toulon), François Vassal (CHU Saint-Etienne), Benjamin Pommier (CHU Saint-Etienne), Emmanuel Gay (CHU Grenoble), Emmanuel De Schlichting (CHU Grenoble), Hassan El-Fertit (CHU Nîmes), André Maillard (CH Perpignan), Emmanuel Mandonnet (APHP – Hôpital Lariboisière), Thibault Passeri (APHP – Hôpital Lariboisière), Jean-Jacques Lemaire (CHU Clermont-Ferrand), Rémy Chaix (CHU Clermont-Ferrand), Mathilde Fouet (HIA Percy – Clamart), Jean-Christophe Sol (CHU Toulouse), Imène Djidjelli (CHU Toulouse), Stéphane Gaillard (Paris – Foch), Olivier Langlois (CHU Rouen), François-Xavier Ferracci (CHU Rouen), Henri Dufour (APHM – La Timone) Pierre-Hugues Roche (APHM – Hôpital Nord), Sébastien Boissonneau (APHM – La Timone), Christine Desenclos (CHU Amiens), Thierry Faillot (APHP – Beaujon), Ilyess Zemmoura (CHU Tours), Pierre-Jean Le Reste (CHU Rennes)
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TP, LB and JG designed and conceptualized the study. TP, DM, JP, CD, SZ and all members from the French Brain Tumor DataBase and the Club de Neuro-Oncologie of the Société Française de Neurochirurgie had a major role in the acquisition of data. TP and DM analyzed and interpreted the data. TP, LB and JG drafted the manuscript. All authors critically revised the manuscript for intellectual content and approved the final version.
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Drs. Thiébaud Picart, David Meyronet, Johan Pallud, Chloé Dumot, Philippe Metellus, Sonia Zouaoui, Moncef Berhouma, François Ducray, Luc Bauchet, Jacques Guyotat, all members of the French Brain Tumor DataBase and Club de Neuro-Oncologie of the Société Française de Neurochirurgie declare that they have no conflict of interest.
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This study was approved by the French legislation (CCTIRS n°10.548; CNIL n°911013). The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Picart, T., Meyronet, D., Pallud, J. et al. Management, functional outcomes and survival in a French multicentric series of 118 adult patients with cerebellar glioblastoma. J Cancer Res Clin Oncol 147, 1843–1856 (2021). https://doi.org/10.1007/s00432-020-03474-6
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DOI: https://doi.org/10.1007/s00432-020-03474-6