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ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2020

Gliomatosis cerebri (GC) or GC-like? A picture to be reconsidered in neuro-oncology based on large retrospective analysis of GC series.

Elena Anghileri, Carla Schettino, Bianca Pollo, Mariangela Farinotti, Antonio Silvani, Rosina Paterra, Monica Patanè, Francesco DiMeco, Maria Grazia Bruzzone, Marica Eoli and 1 more

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Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Elena AnghileriMolecular Neuro-Oncological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. elena.anghileri@istituto-besta.it.ORCID http://orcid.org/0000-0001-7383-3108
Carla SchettinoMolecular Neuro-Oncological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Bianca PolloDepartment of Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Mariangela FarinottiNeuroepidemiology - Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Antonio SilvaniNeuro-Oncological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Rosina PaterraMolecular Neuro-Oncological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Monica PatanèDepartment of Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Francesco DiMecoDepartment of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Maria Grazia BruzzoneNeuro-Radiological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Marica EoliMolecular Neuro-Oncological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Valeria CuccariniNeuro-Radiological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionGliomatosis cerebri (GC), defined until 2016 as a distinct astrocytic glioma entity, has been removed from the 2016 World Health Organization classification of tumors of the central nervous system. However, its identity is still debated. MATERIALS AND

methodsWe retrospectively present 122 patients, including a subgroup with histology confirmation (n = 75, cohort b).

resultsRadiological features showed extension limited to 3 lobes in 31%; bilateral, midline, and basal ganglia and subtentorial involvement in 95%, 52%, 84%, and 60%, respectively; and contrast enhancement in 59.5%. Perioperative mortality occurred in 4%. Histology concluded for grades II, III, and IV, respectively, in 31%, 35%, and 22% (not specified in 12%). Thirty-one percent had isocitrate dehydrogenase (IDH) 1 mutation. Treatments included radiotherapy in 51.2% and chemotherapy in 74.5%. Median overall survival was 17 months. Negative prognostic factors for survival were older age, poorer Karnofsky Performance Scale (KPS), subtentorial, midline and disseminated disease, and lack of chemotherapy, at univariate analysis. At multivariate analysis, KPS ≥ 80, chemotherapy, and subtentorial and disseminated disease remained prognostic (p < 0.0001). For cohort b, same prognostic factors were confirmed, except for midline location, at univariate analysis; at multivariate analysis, only KPS ≥ 80 and chemotherapy remained prognostic (p < 0.0001).

conclusionWe described clinical, neuroimaging, management, and histomolecular features of one of the largest GC series. We identified KPS ≥ 80, radiological pattern as subtentorial localization and dissemination, and chemotherapy as prognostic factors, at multivariate analysis. Planning prospective study, associated to focused genetic assays, could help to clarify if GC has specific features that may result in the identification as a separate entity from other gliomas.

Indexed as

Brain NeoplasmsGliomaNeoplasms, NeuroepithelialAgedHumansPrognosisProspective StudiesRetrospective StudiesChemotherapyDisseminated diseaseGliomatosis cerebriPrognostic factorsSubtentorial involvement

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