scholarly journals Progression Free -survival According to Simpson Grade Resection and Histological Types of Meningiomas in the Mexican Population Progression Free-survival of Meningiomas in the Mexican Population

2021 ◽  
Author(s):  
José Omar Santellán Hernández ◽  
Daniel Alejandro Vega Moreno ◽  
Héctor Eduardo Velázquez Domínguez ◽  
Alexis Oziel Martínez Nava ◽  
Julio Cesar López Valdés ◽  
...  
Keyword(s):  
Latin American ◽  
World Literature ◽  
Progression Free Survival ◽  
The United States ◽  
Histological Type ◽  
Mexican Population ◽  
Cns Tumors ◽  
Who Grade ◽  
Free Survival ◽  
Simpson Grade

Abstract Introduction: Meningiomas are the most common primary central nervous system (CNS) tumors, with an incidence of 8.14 per 100,000 habitants. They represent 30% of all adult primary brain tumor diagnoses in the United States in contrast to Latin America with 50%. In Mexico, there are no epidemiological trends of meningiomas or other CNS tumors. Simpson resection grade and WHO grade are the prognostic factors with the greatest effect. In this paper, we describe the correlation between the survival free of disease and the gross total resection with its histological type according to Simpson’s grading scale. Materials and methods: A descriptive, analytical, retrospective, case-control study was conducted in two public third -level hospitals and three second- level hospitals in two cities of Mexico, (Mexico City and Guadalajara, Jalisco in a period of 10 years (2010-2020). An analysis of measures of central tendency was performed for age, sex, location, histological type, and postsurgical Simpson grade.Results: 26 patients of 179 had recurrence. Among the total recurrences, 15.4% were Simpson 1, 69.2%Simpson 2, and 15.4%Simpson 3. The survival for Simpson 1 was 142.0 months, Simpson 2 90.32 months, and Simpson 3 69.13 months. According to the histological type, the meningiomas with the lowest survival were the microcystic ones with 60 months, followed by the atypical ones with 90.4 months, and the psammomatous ones with 99.8 months. Conclusion: Surgical resection and the histological type are factors that affect progression free -survival. The Mexican population presents characteristics similar to those described in world literature.Importance of the study: This is the first study of its kind in the Mexican population and lays the foundations for future studies in the Latin American population.

scholarly journals A Retrospective Interventional Cohort Study to Assess the Safety and Efficacy of Sandostatin LAR(octreotide) for Treatment of Recurrent and/or Refractory Meningiomas

2019 ◽  
Author(s):  
Daniela Annenelie Bota ◽  
Maya Hrachova ◽  
Beverly D. Fu ◽  
Xiao–Tang Kong ◽  
Gilbert Cadena ◽  
...  
Keyword(s):  
Overall Survival ◽  
Somatostatin Receptors ◽  
Somatostatin Analogs ◽  
Retrospective Chart Review ◽  
Progression Free Survival ◽  
The United States ◽  
High Recurrence Rate ◽  
Who Grade ◽  
Free Survival ◽  
The University

Abstract Background Meningiomas are the most common adult primary intracranial tumors in the United States. Despite, high recurrence rate of atypical and malignant subtypes, there is no approved drug indicated specifically for meningioma. Majority of meningiomas exhibit high density (70%) of somatostatin receptors subtypes, and somatostatin analogs have been under close investigation as a potential treatment option for management of progressive or recurrent meningiomas. The aim of this study was to evaluate efficacy and safety of Sandostatin LAR (octreotide) in patients with progressive and/or recurrent meningioma. Methods A total of 44 patients ≥ 18 years old were included in retrospective chart review. They were diagnosed with meningioma and underwent therapy with Sandostatin LAR (octreotide) from 01/01/10 until 06/01/17 at the University of California, Irvine. Six months progression free survival (PFS6) was defined as a primary endpoint, and the overall survival (OS) was a secondary endpoint along with safety and toxicity. Results The PFS6 months for all tumor grades was 80.6%. The OS for 6 months, 1 year, and 3 years for all WHO grades was 94.9% (95% confidence interval [CI]: 0.88-1.00), 88.4% (95% CI: 0.78-0.99), and 67.2% (95% CI: 0.36-0.99) respectively. Median TTP for WHO grade I, II and III was 3.1, 2.40, and 0.20 years respectively. Sandostatin LAR (octreotide) was well tolerated. Conclusions This is the largest reported retrospective analysis of meningioma patients treated with Sandostatin LAR (octreotide) and suggests that this treatment has minimal to no adverse events and could prolong overall survival and progression free survival.

The relevance of Simpson Grade I and II resection in modern neurosurgical treatment of World Health Organization Grade I meningiomas

2010 ◽  
Vol 113 (5) ◽  
pp. 1029-1035 ◽  
Author(s):  
Michael E. Sughrue ◽  
Ari J. Kane ◽  
Gopal Shangari ◽  
Martin J. Rutkowski ◽  
Michael W. McDermott ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Information ◽  
Progression Free Survival ◽  
World Health ◽  
Rank Test ◽  
Who Grade ◽  
Free Survival ◽  
Simpson Grade ◽  
Kaplan Meier ◽  
Significant Difference

Object In 1957, Simpson published a seminal paper defining the risk factors for recurrence following surgical treatment of intracranial meningiomas. Given that Simpson's study was published more than 50 years ago, preceding image guidance technology and MR imaging, the authors reviewed their own experience with surgical treatment of Grade I meningiomas to determine if Simpson's grading scale is still relevant to modern neurosurgical practice. Methods From this cohort, the authors evaluated all patients undergoing craniotomy for resection of a histologically proven WHO Grade I meningioma as their initial therapy. Clinical information was retrospectively reconstructed using patient medical records and radiological data. Recurrence analysis was performed using the Kaplan-Meier method. Results The 5-year recurrence/progression-free survival for all patients receiving a Simpson Grade I, II, III, or IV resection was 95, 85, 88, and 81%, respectively (p = not significant, log-rank test). Kaplan-Meier analysis revealed no significant difference in recurrence-free survival between patients receiving a Simpson Grade I, II, III, or IV resection. Analysis limited to meningiomas arising from the skull base (excluding the cavernous sinus) similarly found no significant benefit to Simpson Grade I or II resection, and the survival curves were nearly superimposed. Conclusions In this study of a cohort of patients undergoing surgery for WHO Grade I meningiomas, the authors demonstrate that the benefit of more aggressive attempts to resect the tumor with dura and underlying bone was negligible compared with simply removing the entire tumor, or even leaving small amounts of tumor attached to critical structures. The authors believe that these data reflect an evolution in the nature of meningioma surgery over the past 2 decades, and bring into question the relevance of using Simpson's grading system as the sole predictor of recurrence.

scholarly journals RTID-05. INDIGO: A GLOBAL, RANDOMIZED, DOUBLE-BLIND, PHASE 3 STUDY OF VORASIDENIB (AG-881) VS PLACEBO IN PATIENTS WITH RESIDUAL/RECURRENT GRADE II GLIOMA WITH AN ISOCITRATE DEHYDROGENASE 1/2 (IDH1/2) MUTATION

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii194-ii194
Author(s):  
Ingo Mellinghoff ◽  
Martin van den Bent ◽  
Jennifer Clarke ◽  
Elizabeth Maher ◽  
Katherine Peters ◽  
...  
Keyword(s):  
High Risk ◽  
Dose Escalation ◽  
Objective Response ◽  
Data Monitoring Committee ◽  
Progression Free Survival ◽  
High Risk Population ◽  
Low Grade ◽  
Who Grade ◽  
Free Survival ◽  
Grade Ii

Abstract BACKGROUND Low-grade gliomas (LGGs; WHO grade II) are incurable and ultimately progress to high-grade gliomas. The current treatment options are surgery followed by observation (“watch and wait”) for patients with lower risk for disease progression or postoperative chemoradiotherapy (high-risk population). There are no approved targeted therapies. IDH1 and IDH2 mutations (mIDH1/2) occur in approximately 80% and 4% of LGGs, respectively, and promote tumorigenesis via neomorphic production of D-2-hydroxyglutarate. Vorasidenib, an oral, potent, reversible, brain-penetrant pan-inhibitor of mIDH1/2, was evaluated in 76 patients with glioma in two phase 1 studies (dose escalation and perioperative) and was associated with a favorable safety profile at daily doses below 100 mg. Preliminary clinical activity was observed in non-enhancing glioma patients in both studies, with an objective response rate (ORR) of 18.2% and median progression-free survival of 31.4 months in the dose escalation study. METHODS Approximately 366 patients will be randomized 1:1 to vorasidenib (50 mg QD) or matched placebo and stratified by 1p19q status (intact vs co-deleted). Key eligibility criteria: age ≥ 12 years; grade II oligodendroglioma or astrocytoma (per WHO 2016 criteria) not in need of immediate treatment and without high-risk features; centrally confirmed mIDH1/2 status; ≥ 1 surgery for glioma with most recent ≥ 1 year but ≤ 5 years before randomization, and no other anticancer therapy; Karnofsky performance status ≥ 80%; and centrally confirmed measurable, non-enhancing disease evaluable by magnetic resonance imaging. Crossover from placebo to the vorasidenib arm is permitted upon centrally confirmed radiographic progression per RANO-LGG criteria. Primary endpoint: progression-free survival assessed by independent review. Secondary endpoints: safety and tolerability, tumor growth rate assessed by volume, ORR, overall survival, and quality of life. Clinical data will be reviewed regularly by an independent data monitoring committee. The study is currently enrolling patients in the US, with additional countries planned (NCT04164901).

scholarly journals PCV chemotherapy alone for WHO grade 2 oligodendroglioma: prolonged disease control with low risk of malignant progression

2021 ◽  
Author(s):  
Jonathan Weller ◽  
Sophie Katzendobler ◽  
Philipp Karschnia ◽  
Stefanie Lietke ◽  
Rupert Egensperger ◽  
...  
Keyword(s):  
Stereotactic Biopsy ◽  
Tumor Volume ◽  
Progression Free Survival ◽  
Who Grade ◽  
Free Survival ◽  
First Relapse ◽  
Pcv Chemotherapy ◽  
Grade 3 ◽  
Histological Progression

Abstract Introduction The role of chemotherapy alone in newly diagnosed WHO grade 2 oligodendroglioma after biopsy, incomplete or gross total resection remains controversial. We here analyze the clinical outcome of four patient cohorts being treated with either procarbazine, CCNU and vincristine (PCV) or temozolomide (TMZ) after biopsy, resection only, or wait-and-scan after biopsy. Methods Patients (n = 142) with molecularly defined oligodendroglioma (WHO 2016) were assigned to four cohorts: W&S, wait-and-scan after stereotactic biopsy (n = 59); RES, surgical resection only (n = 27); TMZ, temozolomide after biopsy (n = 26) or PCV (n = 30) after biopsy. Presurgical MRI T2 tumor volumes were obtained by manual segmentation. Progression-free survival (PFS), post-recurrence PFS (PR-PFS) and rate of histological progression to grade 3 were analyzed. Results PFS was longest after PCV (9.1 years), compared to 5.1 years after W&S, 4.4 years after RES and 3.6 years after TMZ. The rate of histological progression from grade 2 to 3 within 10 years was 9% for the PCV, 29% for the W&S, 67% for the RES and 75% for the TMZ group (p = 0.01). In the W&S group, patients treated with PCV at first relapse had a longer PFS from intervention than those treated with TMZ (7.2 vs 4.0 years, p = 0.04). Multivariate analysis identified smaller tumor volume prior to any intervention (p = 0.02) to be prognostic for PFS. Conclusions PCV chemotherapy alone is an effective treatment for WHO grade 2 oligodendroglioma, with long PFS and low rate of histological progression.

scholarly journals Sodium Fluorescein-Guided Resection under the YELLOW 560 nm Surgical Microscope Filter in Malignant Gliomas: Our First 38 Cases Experience

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Ningning Zhang ◽  
Hailong Tian ◽  
Dezhang Huang ◽  
Xianbing Meng ◽  
Wenqiang Guo ◽  
...  
Keyword(s):  
Malignant Gliomas ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
Subtotal Resection ◽  
Sodium Fluorescein ◽  
Who Grade ◽  
Free Survival ◽  
Surgical Microscope ◽  
Yellow 560 ◽  
High Fluorescence

Objective. Sodium fluorescein (FL) had been safely used in fluorescence-guided microsurgery for imaging various brain tumors. Under the YELLOW 560 nm surgical microscope filter, low-dose FL as a fluorescent dye helps in visualization. Our study investigated the safety and efficacy of this innovative technique in malignant glioma (MG) patients. Patients and Method. 38 patients suffering from MGs confirmed by pathology underwent FL-guided resection under YELLOW 560 nm surgical microscope filter. We retrospectively analyzed the clinical characters, microsurgery procedure, extent of resection, pathology of MGs, progression-free survival (PFS), and overall survival (OS). Results. Thirty-eight patients had MGs (10 WHO grade III, 28 WHO grade IV). With YELLOW 560 nm surgical microscope filter combined with neuronavigation, sodium fluorescein-guided gross total resection (GTR) was achieved in 35 (92.1%) patients and subtotal resection in 3 (7.69%). The sensitivity and specificity of FL were 94.4% and 88.6% regardless of radiographic localization. Intraoperatively, 10 biopsies (10/28 FL[+]) showed “low” or “high” fluorescence in non-contrast-enhancement region and are also confirmed by pathology. Our data showed 6-month PFS of 92.3% and median survival of 11 months. Conclusion. FL-guided resection of MGs under the YELLOW 560 nm surgical microscope filter combined with neuronavigation was safe and effective, especially in non-contrast-MRI regions. It is feasible for improving the extent of resection in MGs especially during emergency cases.

The effect of statins on overall survival and progression-free survival in veterans with prostate cancer: A retrospective single-center experience.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 169-169
Author(s):  
Brian Warnecke ◽  
Raissa Lakene Djoufack Djoumessi ◽  
Juan Garza ◽  
Michael Mader ◽  
Shreya Chaudhary ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Progressive Disease ◽  
Progression Free Survival ◽  
The United States ◽  
Inverse Association ◽  
Free Survival ◽  
End Point ◽  
Anti Cancer ◽  
Statin Use

169 Background: Prostate cancer is the most common cancer in men in the United States. Death in prostate cancer patients is often related to other medical conditions and not prostate cancer itself. Hence, it is important to optimize other co-morbidities, such as hyperlipidemia, hypertension, and cardiovascular diseases in these patients. However, there are numerous studies portraying the ability of statins to increase progression free survival and overall survival of prostate cancer. This has led to significant interest of statins having anti-cancer properties and ultimately improving long term outcomes. Methods: This is a retrospective observational study with chart review of 1,011 patients diagnosed with prostate cancer from 1995 to 2010 in a VA Hospital in San Antonio, Texas. Variables included age at diagnosis, statin use, type of statin (1st, 2nd, or 3rd generation), dose of statin (4 dosage levels), length of statin use, time followed in months (from diagnosis to death or end of study period), death, cause of death, and time to first progressive disease. Progressive disease was defined using PSWG2 guidelines which is PSA increase > / = 25% and at least 2ng/dl above the nadir. The Cox proportional hazards regression model was used to estimate the hazard function, with age, co-morbities and other cancers used as a covariate. End points were death by prostate cancer (56), death by any cancer (140), and death by all causes (484). We also looked at the effects of statins on progression free survival of prostate cancer. Results: The hazard ratio (HR) for use of statins and death by prostate cancer was 0.35, 95% confidence interval (CI): 0.20-0.62 (p = 0.0003), indicating that statin use has a statistically significant positive effect at delaying death by prostate cancer. Death by any cancer was significantly affected by statins with a HR of 0.47, 95% CI: 0.32-0.65 (p < 0.0001). Death by all causes was also affected significantly by statins with a HR of 0.64, 95% CI: 0.53-0.78 (p < 0.0001). Length of statin use, shorter versus longer than 4 years, showed an inverse association with our primary end point with a HR of 0.53, 95% CI: 0.40-0.69 (p < 0.0001). Dose level of statin, fourth level vs 1, 2, and 3, also showed an inverse association with our primary end point with a HR of 0.73, 95% CI: 0.57-0.94 (p = 0.014). Lastly, statin exposure significantly increased progression-free survival with a HR of 0.71, 95% CI: 0.53-0.95 (p < 0.021). Conclusions: It is clear that concomitant statin use increases overall survival in patients with prostate cancer, potentially even having anti-cancer protective effects against mortality. Longer duration of statin use and higher dose levels of statins increase length of overall survival in patients with prostate cancer. As mortality is often not due to prostate cancer, more interestingly, statin exposure is also shown to increase progression-free survival.

scholarly journals Everolimus and Bevacizumab in the Management of Recurrent, Progressive Intracranial NF2 Mutated Meningioma

2019 ◽  
Vol 12 (1) ◽  
pp. 126-130 ◽  
Author(s):  
Vinay Mathew Thomas ◽  
Poorva Bindal ◽  
James J. Vredenburgh
Keyword(s):  
Survival Time ◽  
Progression Free Survival ◽  
Genetic Alteration ◽  
Cns Tumors ◽  
Good Effect ◽  
Genomic Sequencing ◽  
Low Grade ◽  
High Grade ◽  
Free Survival

Meningiomas are primary CNS tumors that arise from the arachnoid layer of the meninges. Genomic sequencing has revealed that NF2 mutations are the most common genetic alteration seen in meningiomas. Meningiomas although usually low grade, can sometimes progress to high grade. A patient who had several recurrences of meningiomas since childhood presented with recurrent headaches. Imaging showed that he had another recurrence of a meningioma. He underwent surgery for resection of the meningioma and histopathology showed NF2 mutation. He was started on everolimus and bevacizumab with good effect. Studies have shown that NF-2 mutated meningiomas have a good response to everolimus and bevacizumab with increased progression-free survival time and progression-free survival time at 6 months.

scholarly journals P14.95 Is the pathological-grade relevant in “IDH-wild type, TERT-mutant” diffuse-gliomas? An analysis in 147 patients

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii90-iii90
Author(s):  
A E Danyeli ◽  
C B Akyerli ◽  
A Dinçer ◽  
E Coşgun ◽  
U Abacıoğlu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Progression Free Survival ◽  
Genetic Alterations ◽  
Lower Grade ◽  
Wild Type ◽  
Ki 67 ◽  
Who Grade ◽  
Free Survival ◽  
Tert Promoter ◽  
Diffuse Gliomas

Abstract BACKGROUND Although the word “glioblastoma” still denotes a grade-IV pathology, basic molecular studies have clearly indicated that a significant proportion of lower-grade gliomas harbor genetic alterations typical of glioblastomas. Based on these findings cIMPACT-NOW update 3 has defined an entity called the “diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV”. A TERT-promoter mutation is one of these typical molecular markers of glioblastomas. In this study we analyzed IDH-wild type, TERT-mutant diffuse gliomas of different pathological grades to look for differences in demographic, clinical and survival characteristics. MATERIAL AND METHODS 147 adult hemispheric diffuse-gliomas with wild-type IDH1/2 and mutant TERT-promoter (C228T or C250T) were retrospectively analyzed. Primary thalamic, cerebellar brainstem or spinal cases were excluded. 126 (86%), 16(11%) and 5(3%) patients were WHO grade IV, III and II respectively. After surgical treatment or stereotactic biopsy all patients underwent chemoradiation. Median follow-up was 16mo (1–110). Tumors of different grades were compared for age, gender, multifocality, gliomatosis pattern, Ki-67 index, progression-free survival and overall-survival. RESULTS Mean age at presentation for grade II, III and IV were comparable (58.1, 58 and 58.1; ANOVA, p=0.72). There was a slight male predominance in both lower-grades and WHO-grade IV (M:F ratios 1.625 and 1.74). Mean Ki-67 index was significantly higher in higher grades (0.06, 0.14 and 0.25 for grades II, III and IV; ANOVA, p=0.001). Multifocality was comparable (chi-sq, p=1) in lower-grades (3/21; 14.3%) vs. WHO-grade IV (18/126; 14.3%). Gliomatosis pattern was comparable (chi-sq, p=0.095) in lower-grades (2/21; 9.5%) vs. (3/126; 2.3%). Median recurrence free survival (RFS) was 16 months (0–63) in lower-grades and 8months (1–50) in WHO-grade IV. PFS was significantly different between 3 WHO-grades (Log rank, p=0.007) and also between lower-grades and WHO-grade IV (Log rank, p=0.002). Median overall survival was 26 months(2–110) in lower-grades and 15mo(1–91) in WHO-grade IV. OS was significantly different between 3 WHO-grades (Log rank, p=0.014) and also between lower-grades and WHO-grade IV (Log rank, p=0.007). CONCLUSION Increasing pathological grades of hemispheric “IDH-wild type, TERT-mutant diffuse gliomas” have similar demographic and clinical characteristics but incrasing proliferation indices, decrasing progression free survival and shorter overall survival. The findings may be suggesitve of different grades of one common tumor entity.

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