scholarly journals Tumor Type, Epilepsy Burden, and Seizure Documentation: Experiences at a Single Center Neuro-Oncology Clinic

2021 ◽  
Author(s):  
Omar Bushara ◽  
Alex Guzner ◽  
Elizabeth Bachman ◽  
Roger Stupp ◽  
Rimas V Lukas ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Clinical Practice ◽  
Brain Tumors ◽  
Antiepileptic Drug ◽  
Retrospective Review ◽  
Future Research ◽  
Tumor Type ◽  
Single Center ◽  
Metastatic Brain Tumors ◽  
Full Cohort

Abstract Background Patients with both primary and metastatic brain tumors have significant seizure burden due to their tumor. The management of tumor related epilepsy (TRE) and optimizing antiepileptic drug (AED) regimen requires collaboration between neurologists and seizure specialists, which is facilitated by seizure documentation in clinic notes. We aim to describe seizure incidence in patients seen in neuro-oncology clinical practice. Further, in the subset of those patients with TRE, we aim to analyze seizure documentation. Methods This is a retrospective review of patients with a primary or metastatic brain tumor seen in a neuro-oncology clinic in October 2019. Patients with TRE were included in the analysis of seizure documentation. These notes were analyzed for inclusion of seizure descriptors, terminology, AED regimens, and changes in management. Results Of the full cohort of 356 patients, 199 (55.9%) had TRE. Anaplastic astrocytomas had the highest percentage of patients with TRE. The analysis of seizure documentation in patients with TRE revealed that the majority of notes (90.9%) mentioned seizures. Fewer notes (39.6%) provided additional descriptions of the seizures or commented on AED regimens (58.3%). In notes for patients who had seizures within the previous 6 months, seizure descriptors were more likely. Conclusions This study defines the TRE burden in a cohort of patients seen in neuro-oncology clinic. Among patients with TRE, our study shows that documentation of many aspects of the characteristics and management of patient seizures can be improved, which would facilitate further analysis of impact on patient care as well as future research.

Tumor Type, Epilepsy Burden, and Seizure Documentation: Experiences at a Single Center Neuro-Oncology Clinic

2021 ◽  
Author(s):  
Omar Bushara ◽  
Alex Guzner ◽  
Elizabeth Bachman ◽  
Roger Stupp ◽  
Rimas V Lukas ◽  
...  
Keyword(s):  
Descriptive Analysis ◽  
Metastatic Tumor ◽  
Primary Brain Tumor ◽  
Tumor Type ◽  
Single Center ◽  
Metastatic Brain Tumors ◽  
Full Cohort ◽  
Impact Patient Care ◽  
Tumor Types ◽  
Representative Cohort

Abstract Purpose: Patients with both primary and metastatic brain tumors have significant seizure burden due to their tumor. We aim to describe seizure incidence in patients seen in neuro-oncology clinical practice. In addition, as the management of tumor related epilepsy (TRE) may require collaboration between subspecialists, documentation regarding seizures and AEDs is evaluated.Methods: This is a retrospective review of patients with a primary brain tumor or brain metastases seen in a neuro-oncology clinic in a 30 day period. A total of 356 unique patients were used in the descriptive analysis of seizure burden. 199 of these patients had TRE and were included in the analysis of seizure documentation. Results: Of the full cohort of patients, 55.3% (197/356) had TRE. The most common primary tumor was glioblastoma (GBM) (35.7%) and the most common metastatic tumor was breast cancer (51.2% of metastatic tumors). Of all tumor types, anaplastic astrocytomas had the highest percentage of patients with TRE (42.9%).The analysis of seizure documentation in patients with TRE revealed that the majority of notes (90.9%) mentioned seizures; however, fewer notes provided seizure frequency (51.3%), seizure descriptions (39.7%) or commented on AED regimens (58.3%).Conclusion: This study defines a representative cohort of patients seen in neuro-oncology clinic. Among patients with TRE, details regarding seizures and antiepileptic regimens are often not documented in clinic notes. Improved documentation could facilitate further research in this population and impact patient care.

EPID-17. COMPARATIVE EPIDEMIOLOGY OF PRIMARY BRAIN TUMORS AMONG ADOLESCENTS AND YOUNG ADULTS (AYA)

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi89-vi89
Author(s):  
Nayan Lamba ◽  
Bryan Iorgulescu
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Cox Regression ◽  
Adolescent And Young Adult ◽  
Lower Grade ◽  
Diffuse Glioma ◽  
Tumor Type ◽  
Primary Brain Tumors ◽  
Diffuse Gliomas ◽  
Hiv Aids

Abstract INTRODUCTION We utilized national registry data to evaluate the unique epidemiology of primary adolescent and young adult (AYA) brain tumors according to the WHO2016 classification. METHODS AYA patients (15≤age≤39) presenting between 2004-2017 with a brain tumor were identified by ICD-O-3 coding from the National Cancer Database (comprising >70% of newly-diagnosed cancers in the U.S.), and compared to pediatric and adult populations. Epidemiology and overall survival (estimated by Kaplan-Meier techniques and multivariable Cox regression) were assessed by WHO2016 tumor type. RESULTS 108,705 AYA brain tumor patients were identified (56.9% female), compared to 23,928 pediatric (46.8% female) and 748,272 adult (55.6% female) patients. Among the 69.4% of AYA brain tumors with pathological diagnosis, diffuse gliomas (31.4%), sellar tumors (19.2%), and meningiomas (15.3%) predominated in both sexes. Diffuse glioma (31.4%), sellar (19.2%), cranial nerve (7.3%), and mesenchymal non-meningothelial (4.1%) tumors represented a greater proportion of AYA brain tumors than in either pediatric or adult populations. A majority of all intracranial GCTs (59.2%) and neuronal & mixed neuronal-glial tumors (51.6%) presented during AYA. Although the prevalence of diffuse gliomas was similar between AYAs and adults, AYA gliomas were more likely to be grade 2-3 astrocytomas (38.9% vs 14.3%) and oligodendrogliomas (19.3% vs 4.3%) than in adults. GBMs represented 76.0% of adult diffuse gliomas vs. only 25.7% of AYA diffuse gliomas, but with a similar prevalence of MGMT promoter methylation (40.8% vs 38.4%). Notably, 50.7% of AYA PCNSLs were associated with HIV/AIDS, vs only 7.1% in adults (p< 0.001). CONCLUSIONS The distribution, epidemiology, and survival outcomes of primary brain tumors in the AYA population are distinct from their pediatric and adult counterparts. Notably, AYA infiltrative gliomas were more often of lower grade than adults and AYA PCNSL were far more likely to be associated with HIV/AIDS. Primary brain tumors in AYA patients require specialized management.

scholarly journals PS1 - 176 Where Have All the Fat Cells Gone? A Comparative Analysis of Adiposity Patterns in Childhood Brain Tumor Survivors and Non-Cancer Controls

2016 ◽  
Vol 43 (S4) ◽  
pp. S11-S11 ◽  
Author(s):  
K.W. Wang ◽  
E. Kearsley ◽  
N. Falzone ◽  
A. Fleming ◽  
S. Burrow ◽  
...  
Keyword(s):  
Physical Activity ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Survival Rates ◽  
Visceral Adiposity ◽  
Activity Levels ◽  
Tumor Type ◽  
Technological Advances ◽  
Cardiometabolic Disorders ◽  
Fried Foods

Brain tumors are the most common solid tumors in children in Canada. While technological advances have increased their survival rates, survivors of childhood brain tumors (SCBT) often develop obesity, which can reduce lifespan and quality of life. While adiposity is a known factor for cardiometabolic disorders in the general population, adiposity patterns in SCBT have not been determined. This study aims to investigate how adiposity patterns differ between SCBT and non-cancer controls, and how lifestyle and treatment factors may contribute to these patterns. Methods: Fifty-nine SCBT and 108 non-cancer controls were recruited from the clinics at McMaster Children’s Hospital. Sociodemographic and lifestyle details were collected using standardized tools to assess diet, physical activity, and sleep. Brain tumor type, location and treatment details were obtained from medical records. Total and visceral adiposity were determined by total fat mass (FM) as well as waist-to-hip (WHR) and waist-to-height ratio (WHTR). Results: SCBT have higher total and visceral adiposity, while BMI is similar to controls. Female SCBT who received radiotherapy and/or chemotherapy have higher adiposity. A dietary pattern of white bread and fried foods with low dark bread was positively associated with adiposity. Lower physical activity levels, but not sleep durations, were associated with higher adiposity. Conclusion: SCBT have higher visceral and total adiposity than non-cancer controls. Sex, chemoradiotherapy, high fat diet, and physical inactivity, can contribute to these adiposity patterns. These results provide multiple points of entry to design interventions that reduce adiposity, and may improve long-term outcomes in SCBT.

scholarly journals Cerebrospinal Fluid MicroRNA Signatures as Diagnostic Biomarkers in Brain Tumors

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1546 ◽  
Author(s):  
Alena Kopkova ◽  
Jiri Sana ◽  
Tana Machackova ◽  
Marek Vecera ◽  
Lenka Radova ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Low Grade ◽  
Tumor Type ◽  
Tumor Patients ◽  
Primary Tumors ◽  
Mirna Profiling ◽  
Tumor Types ◽  
Cns Malignancies

Central nervous system (CNS) malignancies include primary tumors that originate within the CNS as well as secondary tumors that develop as a result of metastatic spread. Circulating microRNAs (miRNAs) were found in almost all human body fluids including cerebrospinal fluid (CSF), and they seem to be highly stable and resistant to even extreme conditions. The overall aim of our study was to identify specific CSF miRNA patterns that could differentiate among brain tumors. These new biomarkers could potentially aid borderline or uncertain imaging results onto diagnosis of CNS malignancies, avoiding most invasive procedures such as stereotactic biopsy or biopsy. In total, 175 brain tumor patients (glioblastomas, low-grade gliomas, meningiomas and brain metastases), and 40 non-tumor patients with hydrocephalus as controls were included in this prospective monocentric study. Firstly, we performed high-throughput miRNA profiling (Illumina small RNA sequencing) on a discovery cohort of 70 patients and 19 controls and identified specific miRNA signatures of all brain tumor types tested. Secondly, validation of 9 candidate miRNAs was carried out on an independent cohort of 105 brain tumor patients and 21 controls using qRT-PCR. Based on the successful results of validation and various combination patterns of only 5 miRNA levels (miR-30e, miR-140, let-7b, mR-10a and miR-21-3p) we proposed CSF-diagnostic scores for each tumor type which enabled to distinguish them from healthy donors and other tumor types tested. In addition to this primary diagnostic tool, we described the prognostic potential of the combination of miR-10b and miR-196b levels in CSF of glioblastoma patients. In conclusion, we performed the largest study so far focused on CSF miRNA profiling in patients with brain tumors, and we believe that this new class of biomarkers have a strong potential as a diagnostic and prognostic tool in these patients.

scholarly journals 3D extracellular matrix microenvironment in bioengineered tissue models of primary pediatric and adult brain tumors

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Disha Sood ◽  
Min Tang-Schomer ◽  
Dimitra Pouli ◽  
Craig Mizzoni ◽  
Nicole Raia ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Adult Brain ◽  
Metabolic Imaging ◽  
Tumor Type ◽  
Label Free ◽  
Pediatric Ependymoma ◽  
Extracellular Lipid ◽  
Tumor Cell Behavior

Abstract Dynamic alterations in the unique brain extracellular matrix (ECM) are involved in malignant brain tumors. Yet studies of brain ECM roles in tumor cell behavior have been difficult due to lack of access to the human brain. We present a tunable 3D bioengineered brain tissue platform by integrating microenvironmental cues of native brain-derived ECMs and live imaging to systematically evaluate patient-derived brain tumor responses. Using pediatric ependymoma and adult glioblastoma as examples, the 3D brain ECM-containing microenvironment with a balance of cell-cell and cell-matrix interactions supports distinctive phenotypes associated with tumor type-specific and ECM-dependent patterns in the tumor cells’ transcriptomic and release profiles. Label-free metabolic imaging of the composite model structure identifies metabolically distinct sub-populations within a tumor type and captures extracellular lipid-containing droplets with potential implications in drug response. The versatile bioengineered 3D tumor tissue system sets the stage for mechanistic studies deciphering microenvironmental role in brain tumor progression.

scholarly journals 90-gene signature assay for tissue origin diagnosis of brain metastases

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Yulong Zheng ◽  
Yongfeng Ding ◽  
Qifeng Wang ◽  
Yifeng Sun ◽  
Xiaodong Teng ◽  
...  
Keyword(s):  
Gene Expression ◽  
Brain Tumors ◽  
Brain Metastases ◽  
Expression Profiles ◽  
Gene Expression Signature ◽  
Similarity Score ◽  
Primary Site ◽  
Tumor Type ◽  
Metastatic Brain Tumors ◽  
Expression Signature

Abstract Background Brain metastases (BM) are the most common intracranial tumors. 2–14% of BM patients present with unknown primary site despite intensive evaluations. This study aims to evaluate the performance of a 90-gene expression signature in determining the primary sites for BM samples. Methods The sequence-based gene expression profiles of 708 primary brain tumors (PBT) collected from The Cancer Genome Atlas (TCGA) database were analyzed by the 90-gene expression signature, with a similarity score for each of 21 common tumor types. We then used Optimal Binning algorithm to generate a threshold for separating PBT from BM. Eighteen PBT samples were analyzed to substantiate the reliability of the threshold. In addition, the performance of the 90-gene expression signature for molecular classification of metastatic brain tumors was validated in a cohort of 48 BM samples with the known origin. For each BM sample, the tumor type with the highest similarity score was considered tissue of origin. When a sample was diagnosed as PBT, but the similarity score below the threshold, the second prediction was considered as the primary site. Results A threshold of the similarity score, 70, was identified to discriminate PBT from BM (PBT: > 70, BM: ≤ 70) with an accuracy of 99% (703/708, 95% CI 98–100%). The 90-gene expression signature was further validated with 18 PBT and 44 BM samples. The results of 18 PBT samples matched reference diagnosis with a concordance rate of 100%, and all similarity scores were above the threshold. Of 44 BM samples, the 90-gene expression signature accurately predicted primary sites in 89% (39/44, 95% CI 75–96%) of the cases. Conclusions Our findings demonstrated the potential that the 90-gene expression signature could serve as a powerful tool for accurately identifying the primary sites of metastatic brain tumors.

Immunohistochemical Study of Erythropoietin in Cerebellar Hemangioblastomas Associated with Secondary Polycythemia

Neurosurgery ◽  
1991 ◽  
Vol 28 (1) ◽  
pp. 24-26 ◽  
Author(s):  
Osamu Tachibana ◽  
Tetsumori Yamashima ◽  
Junkoh Yamashita
Keyword(s):  
Monoclonal Antibody ◽  
Brain Tumor ◽  
Mast Cells ◽  
Brain Tumors ◽  
Stromal Cells ◽  
Immunohistochemical Study ◽  
Metastatic Brain Tumors ◽  
Secondary Polycythemia

Abstract Although cerebellar hemangioblastomas are known to be associated with secondary polycythemia, the cellular derivation of erythropoietin (EPO) in hemangioblastomas still remains obscure. Specimens from 18 patients with cerebellar hemangioblastomas were immunohistochemically studied using anti-EPO monoclonal antibody. Eight cases of brain tumors, including 2 meningiomas, 2 medulloblastomas, 2 glioblastomas, and 2 metastatic brain tumors were studied as controls. In 9 of 18 cases, EPO-positive cells were scattered around the capillaries and were ultrastructurally shown to be mast cells. These cases were not, however, associated with secondary polycythemia. In contrast, the stromal cells were positive for EPO in 3 cases. Among them, one was associated with secondary polycythemia. Furthermore, one-half of the control cases of brain tumor contained EPO-positive mast cells. Accordingly, it was suggested that mast cells (or small granulocytes) have little relationship to the release of EPO; however, some stromal cells might release EPO with a resultant polycythemia.

scholarly journals Expression and clinical importance of a newly discovered alternative splice variant of the gene for acrosin binding protein found in human brain tumors

2020 ◽  
Vol 14 (6) ◽  
pp. 243-252
Author(s):  
Baolong Zheng
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Splice Variant ◽  
Binding Protein ◽  
Clinical Importance ◽  
Seminiferous Tubules ◽  
Tumor Type ◽  
Splicing Variant ◽  
Tumor Tissues ◽  
Significant Difference

AbstractBackgroundAcrosin binding protein (ACRBP) is a member of the cancer–testis antigen (CTA) family. Normally, ACRBP mRNA is expressed only in seminiferous tubules, while abnormally it is expressed in various types of cancers in tumor tissues, such as brain tumor.ObjectivesTo determine the expression and clinical impact of a newly discovered splice variant of ACRBP in brain tumor.MethodsTotal RNA was extracted and reverse transcribed from 92 tumor specimens and 3 cell lines. Primers were designed to determine the expression of the new splice variant in all the samples. Quantitative real-time PCR (qPCR) was conducted for samples positive in reverse transcriptase-PCR. Association of the expression of ACRBP with the clinicopathological features of the various brain tumors was assessed statistically.ResultsThe primers identified a newly discovered splice variant of ACRBP named ACRBP-V5a. The proportions of samples of the various brain tumor types positive for the ACRBP-V5a splicing variant were as follows: astrocytoma 10/33 (30%), glioblastoma 10/30 (33%), medulloblastoma 14/29 (48%), all tumors 34/92 (37%). Although we did not find a significant difference in the proportions of samples of various types of brain tumor tissues positive for the new splice variant (P > 0.05), levels of expression of the ACRBP-V5a splice variant were significantly different for tumor grade (P = 0.01) and tumor type (P = 0.02).ConclusionsA newly discovered splice variant, ACRBP-V5a, is present in brain tumor. The new splicing variant may have discriminative value and potential importance in molecular-targeted therapy for brain tumors.

scholarly journals MRI Modality-based Brain Tumor Segmentation Using Deep Neural Networks

2021 ◽  
Author(s):  
Pankaj Eknath Kasar ◽  
Shivajirao M. Jadhav ◽  
Vineet Kansal
Keyword(s):  
Neural Networks ◽  
Brain Tumor ◽  
Clinical Practice ◽  
Brain Tumors ◽  
Deep Neural Networks ◽  
Automatic Segmentation ◽  
Brain Mri ◽  
Tumor Segmentation ◽  
Dice Similarity Coefficient ◽  
Manual Segmentation

Abstract The tumor detection is major challenging task in brain tumor quantitative evaluation. In recent years, owing to non-invasive and strong soft tissue comparison, Magnetic Resonance Imaging (MRI) has gained great interest. MRI is a commonly used image modality technique to locate brain tumors. An immense amount of data is produced by the MRI. Heterogeneity, isointense and hypointense tumor properties restrict manual segmentation in a fair period of time, thus restricting the use of reliable quantitative measures in clinical practice. In the clinical practice manual segmentation task is quite time consuming and their performance is highly depended on the operator’s experience. Accurate and automated tumor segmentation techniques are also needed; however, the severe spatial and structural heterogeneity of brain tumors makes automatic segmentation a difficult job. This paper proposes fully automatic segmentation of brain tumors using encoder-decoder based convolutional neural networks. The paper focuses on well-known semantic segmentation deep neural networks i.e., UNET and SEGNET for segmenting tumors from Brain MRI images. The networks are trained and tested using freely accessible standard dataset, with Dice Similarity Coefficient (DSC) as metric for whole predicted image i.e., including tumor and background. UNET’s average DSC on test dataset is 0.76 whereas for SEGNET we got average DSC 0.67. The evaluation of results proves that UNET is having better performance than SEGNET.

Significance of hemorrhage into brain tumors: clinicopathological study

1987 ◽  
Vol 67 (6) ◽  
pp. 852-857 ◽  
Author(s):  
Douglas Kondziolka ◽  
Mark Bernstein ◽  
Lothar Resch ◽  
Charles H. Tator ◽  
J. F. Ross Fleming ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Tumor Type ◽  
Recurrent Tumor ◽  
Content Type ◽  
Intratumoral Hemorrhage ◽  
Clinicopathological Study ◽  
Pathological Review ◽  
Neurological Presentation ◽  
Fine Print

✓ A retrospective clinical and pathological review of 905 consecutive brain tumor cases (excluding pituitary adenoma and recurrent tumor) was conducted to identify cases in which intratumoral hemorrhage was confirmed grossly and/or pathologically. There were 132 cases so identified, for an overall tumor hemorrhage rate of 14.6%; of these, 5.4% were classified as macroscopic and 9.2% as microscopic. The presence of hemorrhage was correlated with the neurological presentation. The highest hemorrhage rate (70.0%) was found in patients with prior neurological history who experienced apoplectic deterioration (acute-on-chronic presentation). Only 57.1% of patients with acute deterioration in the absence of prior neurological symptoms had hemorrhages. The highest hemorrhage rate for primary brain tumors was 29.2% for mixed oligodendroglioma/astrocytoma, while the highest hemorrhage rate for any tumor type was 50% for metastatic melanoma. The clinical relevance of tumor hemorrhage is discussed.

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