Evaluation of RANO response criteria compared to clinician evaluation in WHO grade III anaplastic astrocytoma: implications for clinical trial reporting and patterns of failure

The use of robotic technology in the surgical treatment of brain tumour promises increased precision and accuracy in the performance of surgery. Robotic manipulators may allow superior access to narrow surgical corridors compared to freehand or conventional neurosurgery. This paper reports values and ranges of tool-tissue interaction forces during the performance of glioma surgery using an MR compatible, image-guided neurosurgical robot called neuroArm. The system, capable of microsurgery and stereotaxy, was used in the surgical resection of glioma in seven cases. neuroArm is equipped with force sensors at the end-effector allowing quantification of tool-tissue interaction forces and transmits force of dissection to the surgeon sited at a remote workstation that includes a haptic interface. Interaction forces between the tool tips and the brain tissue were measured for each procedure, and the peak forces were quantified. Results showed maximum and minimum peak force values of 2.89 N (anaplastic astrocytoma, WHO grade III) and 0.50 N (anaplastic oligodendroglioma, WHO grade III), respectively, with the mean of peak forces varying from case to case, depending on type of the glioma. Mean values of the peak forces varied in range of 1.27 N (anaplastic astrocytoma, WHO grade III) to 1.89 N (glioblastoma with oligodendroglial component, WHO grade IV). In some cases, ANOVA test failed to reject the null hypothesis of equality in means of the peak forces measured. However, we could not find a relationship between forces exerted to the pathological tissue and its size, type, or location.

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Gene Expression Profiling in Human High-Grade Astrocytomas

Comparative and Functional Genomics ◽

10.1155/2011/245137 ◽

2011 ◽

Vol 2011 ◽

pp. 1-10 ◽

Cited By ~ 13

Author(s):

Zhongyu Liu ◽

Zhiqiang Yao ◽

Chao Li ◽

Yicheng Lu ◽

Chunfang Gao

Keyword(s):

Gene Expression ◽

Gene Expression Profiling ◽

Expression Profiling ◽

Anaplastic Astrocytoma ◽

Low Grade ◽

Diffuse Astrocytoma ◽

Who Grade ◽

Grade Ii ◽

Who Grade Iii ◽

Grade Iii

Diffuse astrocytoma of (WHO grade II) has a tendency to progress spontaneously to anaplastic astrocytoma (WHO grade III) and/or glioblastoma (WHO grade IV). However, the molecular basis of astrocytoma progression is still poorly understood. In current study, an essential initial step toward this goal is the establishment of the taxonomy of tumors on the basis of their gene expression profiles. We have used gene expression profiling, unsupervised (hierarchal cluster (HCL) and principal component analysis (PCA)) and supervised (prediction analysis for microarrays (PAM)) learning methods, to demonstrate the presence of three distinct gene expression signatures of astrocytomas (ACMs), which correspond to diffuse or low-grade astrocytoma (WHO grade II), Anaplastic astrocytoma (WHO grade III) and Glioblastoma multiforme (WHO grade IV). We also demonstrate a 171 gene-based classifier that characterize the distinction between these pathologic/molecular subsets of astrocytomas. These results further define molecular subtypes of astrocytomas and may potentially be used to define potential targets and further refine stratification approaches for therapy. In addition, this study demonstrates that combining gene expression analysis with detailed annotated pathway and gene ontology (GO) category resources was applied to highly enriched normal and tumor population; it can yield an understanding of the critical biological mechanism of astrocytomas.

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Skeletal spread of an anaplastic astrocytoma (WHO grade III) and preservation of histopathological properties within metastases

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2012.05.025 ◽

2013 ◽

Vol 115 (3) ◽

pp. 323-328 ◽

Cited By ~ 6

Author(s):

T. Martens ◽

J. Matschke ◽

C. Müller ◽

S. Riethdorf ◽

S. Balabanov ◽

...

Keyword(s):

Anaplastic Astrocytoma ◽

Who Grade ◽

Who Grade Iii ◽

Grade Iii

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WHO Grade III Anaplastic Astrocytoma In A 72 Years Old Male-A Case Report

10.21203/rs.3.rs-352548/v1 ◽

2021 ◽

Author(s):

Vikash Jaiswal ◽

Samir Ruxmohan ◽

Sneha Gupta ◽

Namratah Hange ◽

Dattatreya Mukherjee

Keyword(s):

Anaplastic Astrocytoma ◽

Age Groups ◽

Behavioral Problem ◽

Gamma Knife Radiosurgery ◽

Immunohistochemical Analysis ◽

Molecular Therapy ◽

Who Grade ◽

Peripheral Enhancement ◽

Who Grade Iii ◽

Grade Iii

Abstract Glioma is a common type of tumor that originates in the glial cell in brain and is devastating in nature. It can affect all age groups but is more common in adults and has been found more in males than in females with a ratio of 1.3/1. Despite the aggressive treatment it relapsed and can cause mortality because of its infiltrative nature. This WHO type III Anaplastic Astrocytoma is more common in 40-50 years old with a median of 41 years. Here, we report a new case of Glioma occurring in a 72 year old male, who presented with a right sided headache, forgetful, worsening memory, behavioral problem along with increased agitation and irritability. MRI Brain WO/W revealed a mass in the left thalamus and basal ganglia region with a thick rim of peripheral enhancement. Diagnosis of Anaplastic Astrocytoma (WHO Grade III) was confirmed by histology and immunohistochemical analysis of the tumor.Conclusion:It is a case of Left sided WHO GRADE III Anaplastic astrocytoma which is rare in this age group of 72 years. The patient was managed with gamma knife radiosurgery, chemotherapy with Temozolomide (TMZ), and targeted molecular therapy with Bevacizumab. The patient improved with remission of symptoms.

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Anaplastic Astrocytoma WHO Grade III

Imaging Brain Diseases ◽

10.1007/978-3-7091-1544-2_53 ◽

2019 ◽

pp. 1347-1360

Author(s):

Serge Weis ◽

Michael Sonnberger ◽

Andreas Dunzinger ◽

Eva Voglmayr ◽

Martin Aichholzer ◽

...

Keyword(s):

Anaplastic Astrocytoma ◽

Who Grade ◽

Who Grade Iii ◽

Grade Iii

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Radiotherapy with Concomitant Temozolomide in WHO Grade III Glial Tumors

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2008.06.712 ◽

2008 ◽

Vol 72 (1) ◽

pp. S235

Author(s):

F. Zorlu ◽

M. Gurkaynak ◽

U. Selek ◽

S. Ulger ◽

A. Turker ◽

...

Keyword(s):

Who Grade ◽

Glial Tumors ◽

Who Grade Iii ◽

Grade Iii

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High-grade glioma with anterior skull base erosion and intranasal extension: case report

Journal of Neurosurgery ◽

10.3171/2016.4.jns151724 ◽

2017 ◽

Vol 126 (5) ◽

pp. 1484-1487 ◽

Cited By ~ 1

Author(s):

Matthew T. Stib ◽

Michael Johnson ◽

Alan Siu ◽

M. Isabel Almira-Suarez ◽

Zachary Litvack ◽

...

Keyword(s):

Nasal Cavity ◽

Skull Base ◽

Radiation Treatment ◽

High Grade Glioma ◽

Brain Parenchyma ◽

Anterior Skull Base ◽

High Grade ◽

Who Grade ◽

Who Grade Iii ◽

Grade Iii

The authors describe the case of a large WHO Grade III anaplastic oligoastrocytoma extending through the anterior skull base and into the right nasal cavity and sinuses. Glial neoplasms are typically confined to the intracranial compartment within the brain parenchyma and rarely extend into the nasal cavity without prior surgical or radiation therapy. This 42-year-old woman presented with progressive headaches and sinus congestion. MR imaging findings revealed a large intracranial lesion with intranasal extension. Endoscopic nasal biopsy revealed pathology consistent with an infiltrating glioma. The patient subsequently underwent a combined transcranial/endonasal endoscopic approach for resection of this lesion. Pathological diagnosis revealed a WHO Grade III oligoastrocytoma. This report reviews the mechanisms of extradural glioma extension. To the authors' knowledge, it is the second report of a high-grade glioma exhibiting nasal extension without prior surgical or radiation treatment.

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The Expression of Progesterone Receptors in Meningiomas of Different Grades

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v8i2.357 ◽

2019 ◽

Vol 8 (2) ◽

pp. 65-69

Author(s):

Mohammad Tahir ◽

Tehreem Atif ◽

Summaya Sohail ◽

Arfa Nawazish ◽

Huma Mushtaq

Keyword(s):

Progesterone Receptor ◽

Treatment Options ◽

Progesterone Receptors ◽

Lower Grade ◽

Immunoperoxidase Method ◽

Nuclear Staining ◽

Who Grade ◽

Grade Ii ◽

Who Grade Iii ◽

Grade Iii

Background: Meningiomas are slow growing intracranial and intraspinal neoplasms with a tendency to recur locally. WHO grades them as I (benign), II (atypical) and III (anaplastic) in order of their increasing aggressiveness, based on histological parameters and brain parenchymal invasion. Progesterone receptors (PR) are more prevalent amongst the lower grade meningiomas. The objective of this study was to determine the immunohistochemical expression of progesterone receptors in meningiomas of different grades.Material and Methods: A total of 100 cases were selected over a period of 2.5 years. Three to five microns’ thick sections stained with Hematoxylin and Eosin were examined microscopically by a team of two Histopathologists and graded into grades I, II and III, according to 2016 WHO classification criteria. Another section of the original tumor was stained with progesterone receptor antibody using the conventional immunoperoxidase method. Stained slides were than examined by the same team of Histopathologists and declared positive (if nuclear staining was observed in more than 10% of tumor cells) or negative. Statistical analysis was done using SPSS version 21.Results: Out of a total of 100 cases of meningioma, there were 79 cases of benign/typical WHO grade I, 15 cases of atypical/ WHO grade II and 6 cases of anaplastic/ WHO grade III tumor. PR status was positive in 89.8 % (71/79) of grade I meningiomas and 46.6 % (7/15) of grade II/Atypical meningiomas. The 06 cases of Anaplastic/WHO grade III tumors were negative for PR. There was a higher prevalence of Progesterone receptors in female patients (89.8%; 53/59) as compared to male meningioma patients (60.9%; 25/41).Conclusion: We observed a decreased expression of progesterone receptor in higher grades of meningioma in this study. It is an effort to explore conservative treatment options for inoperable lesions, as anti-progesterone therapy may hold a promise as a new treatment option in the near future.

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High-grade gliomas and molecular biology of neurosurgical oncology

Oxford Textbook of Neurological Surgery ◽

10.1093/med/9780198746706.003.0007 ◽

2019 ◽

pp. 89-106

Author(s):

Stephen J Price ◽

Harry Bulstrode ◽

Richard Mair

Keyword(s):

Molecular Markers ◽

Who Classification ◽

High Grade Glioma ◽

High Grade ◽

Optimal Management ◽

Who Grade ◽

Normal Human ◽

Who Grade Iii ◽

Grade Iii

The term high-grade glioma (HGG) encompasses a number of histological entities that are considered by the WHO Classification as WHO Grade III and IV tumours. They have traditionally been considered as having similar behaviour and had been treated in a similar manner but recent advances in our understanding of tumour biology have led to the identification of molecular markers that are now central to the classification of these tumours. Normal human cells develop into cancer cells through a stepwise accumulation of genomic and epigenomic alterations and this chapter considers the molecular markers of gliomas and explains their significance before going on to discuss the optimal management.

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