Gliosarcoma: a clinical study

Background and purpose: Gliosarcomas are rare biphasic neoplasms of the cen tral nervous system composed of a glioblastoma multiforme (GBM) admixed wit h a sarcomatous component. There are conflicting reports regarding their cl inical aggressiveness. Four hundred and twenty-two consecutive patients wit h GBM were treated at our hospital between 1980 and 1999, among them 12 gli osarcomas. The goal of this study was to examine clinical features, treatme nt, survival and patterns of failure of gliosarcoma patients and to compare them with the entire group of GBM patients. This comparison was refined by a matched pair analysis with a group of 12 GBM patients selected for age, Karnofsky performance status, resection status, fractionation scheme and to tal dose (control GBM group). Material and methods: Seven gliosarcoma patients were male, five female, wi th a median age of 56 years (range 37-76 years). The median tumor size was 4.5 cm (range 3-8 cm). The locations, all supratentorial, included temporal in six, parietal in live, frontal in four and occipital in one patient. Al l patients underwent tumor resection followed by postoperative radiation th erapy. Results: Median survival was 11.5 months for the gliosarcoma group, 8.1 mon ths for the entire GBM group (log rank test, P = 0.16) and 11.0 months for the control GBM group (log rank test, P = 0.36), All gliosarcoma patients h ad local tumor recurrences and died due to neurologic causes within 19.3 mo nths after radiation therapy. Conclusions: With regard to clinical features, survival and patterns of fai lure, gliosarcomas and GBM cannot be distinguished clinically. Therefore, t he same principles should be applied for the treatment of these tumors. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.