bluuebunny/crossref_metadata_2025_split huggingface dataset:
NCOG-48. TRANSFORMATION FROM LOW GRADE MENINGIOMA AND PROGNOSTIC FACTORS FOR SHORTER TIME TO RECURRENCE OF WHO GRADE III MENINGIOMA DIAGNOSIS
Authors: Chew Jessica , Chen William , Susko Matthew S , Vasudevan Harish N , Braunstein Steve , Magill Stephen , Raleigh David 
Published: December 2020

Abstract

BACKGROUND
WHO grade III meningiomas are rare, and clinical outcomes data are limited. To address this problem, we analyzed a single institution retrospective cohort of patients with WHO grade III meningiomas.

METHODS
Patients who underwent resection of WHO grade III meningiomas between 1983 and 2019 with available follow-up data were included. Treatment, local recurrence, and overall survival rates were obtained. Kaplan-Meier analysis, log rank tests, and Student’s t tests were used for statistical analyses.

RESULTS
Ninety consecutive patients met inclusion criteria. Median follow-up was 3.2 years (IQR: 1.2-7.9), median age was 58 years (IQR: 46-67). Twenty-three patients (26%) underwent resection alone, and 58 (64%) underwent resection with adjuvant radiotherapy. Fifty-one patients developed local recurrences, with median time to recurrence of 1.0 year (IQR: 0.6-2.9) and higher MIB-1 labeling index for tumors that recurred within 1 year (25% versus 17%, p=0.04). There was a median of 2 recurrences per patient (IQR: 1-3), with a median of 2 resections and 2 radiotherapy courses for initial and salvage treatments. Thirty-nine patients with recurrences died, with median overall survival of 3.7 years (IQR: 1.8-8.8). Thirty-seven patients (41%) had prior low grade meningioma diagnoses with subsequent transformation to grade III, including 6 (7%) with grade I, 16 (18%) with grade II, and 15 (17%) with unknown grade. There was a median of 1 low grade recurrence per patient (IQR: 0-3) before transformation to grade III, which occurred a median of 4.3 years (IQR: 2.4-9.9) after initial diagnosis. Prior low grade diagnosis was associated with shorter time to recurrence of WHO grade III meningioma (p=0.01), and worse overall survival (p=0.03).

CONCLUSION
Patients with WHO grade III meningioma have poor outcomes despite aggressive multimodal therapy, and there is an urgent, unmet need for new high grade meningioma treatments.
NCOG-49. COMBINED NECROSIS AND BRAIN INVASION PREDICT RADIO-RESISTANCE AND TUMOR RECURRENCE IN ATYPICAL MENINGIOMA
Authors: Emili Garcia-Segura Monica , Erickson Anders , Jairath Rishi , Munoz David , Das Sunit 
Published: December 2020

Abstract

BACKGROUND
Meningiomas are the most common tumors in the central nervous system, with variable recurrence rates depending on WHO grading. Atypical (WHO grade II) meningioma has a higher recurrence rate than benign meningioma (WHO grade I). The efficacy of adjuvant radiotherapy (RT) to improve tumor control has been questioned.

METHODS
This cohort study retrospectively reviewed all patients at St. Michaels Hospital Tumor Patient Database with a diagnosis of atypical meningioma (AM) who underwent surgical resection between 1995 and 2015. Patient and tumor characteristics such as location, neuropathological diagnosis, resection extent, RT and time to reoccurrence or progression were recorded. Resection extent was defined by Simpson Grading Scale as either Gross Total (GTR) or Subtotal (STR) resection. Cox univariate regression and Kaplan-Meier survival analysis were employed to identify risk factors for recurrence and radio-resistance.

RESULTS
In our cohort of 181 patients, the combination of necrosis and brain invasion was associated with an increased reoccurrence risk (HR= 4.560, P=0.001) and the lowest progression-free survival relative to other histopathological predictors. This trend was maintained after GTR (P=0.001), whereas necrosis alone and combined necrosis and brain invasion were both associated with low progression-free survival in STR (P=0.001). Radiotherapy was associated with decreased progression-free survival (P=0.001), especially in patients who received GTR (P=0.001). This trend was maintained in patients with necrosis alone (P=0.002) but especially in patients with combined necrosis and brain invasion (P=0.001).

CONCLUSION
Combined necrosis and brain invasion is a strong predictor of tumor recurrence and radio-resistance in AM, regardless of extent of resection or RT.
NCOG-50. CLINICAL AND GENOMIC FACTORS ASSOCIATED WITH SEIZURES IN MENINGIOMAS
Authors: Gupte Trisha , Jin Lan , Li Chang , Yalcin Kanat , Youngblood Mark , Miyagishima Danielle , Mishra Ketu , Fulbright Robert , Erson-omay Zeynep , Gunel Murat , Moliterno Jennifer 
Published: December 2020

Abstract
Clinical and genomic sequencing data of 394 patients surgically treated for meningioma were reviewed to better understand the relationship between seizures and meningiomas. Correlations of clinical and genomic variables and occurrence of preoperative (PRESZ) and postoperative (POSTSZ) seizures were analyzed. 17% of patients presented with PRESZ and used AEDs preoperatively for 46.5 months on average as they were more likely to be treated in the setting of a recurrent tumor (p = 0.042). PRESZ patients were at higher risk for worse progression free survival (HR 2.68, 95% CI 1.30-5.50) and were also more likely to have meningiomas with an NF2-mutation (p = 0.032), higher grade (p = 0.030) and brain invasion (p = 0.009). On multivariate analysis, edema (OR 3.11, 95% CI 1.46-6.65; p = 0.003) and atypical histology (OR 2.00, 95% CI 1.03-3.90; p = 0.041) were positive predictors of PRESZ, while genomic subgroup was not, such that the effect of NF2 mutation was indirectly mediated through atypical histology and edema (p = 0.012). Seizure freedom was achieved in 83.3% of the cohort. 20% of all seizure-free patients were able to discontinue AED use postoperatively and they were more likely to have undergone a GTR (p = 0.031). Edema (OR 13.69, 95% CI 1.19-14.88; p = 0.026), recurrent tumors (OR 7.41, 95% CI 1.27-8.68; p = 0.015), and postoperative radiation (OR 6.37, 95% CI 1.16-7.53; p = 0.023) were significant predictors of POSTSZ. Hedgehog-pathway mutated tumors were associated with POSTSZ in Grade I meningiomas (p = 0.026). While NF2-mutated tumors are significantly associated with PRESZ, this appears due to corresponding edema and atypical histology. Patients who undergo radiation and/or suffer recurrence are at risk for POSTSZ, irrespective of extent of resection. PRESZ may portend a more potentially aggressive molecular entity and challenging clinical course with higher recurrence risk.
NCOG-51. CORRELATION BETWEEN TUMOR VOLUME AND SERUM PROLACTIN AND IMPACT OF TUMOR CELLULAR DENSITY ON PROLACTINOMA SURGICAL OUTCOMES IN A COHORT OF 181 PATIENTS
Authors: Pereira Matheus , Oh Taemin , Joshi Rushikesh , Haddad Alexander , Pereira Kaitlyn , Osorio Robert , Donohue Kevin , Peeran Zain , Sudhir Sweta , Jain Saket , Beniwal Angad , Gurrola José , El-Sayed Ivan , Blevins Lewis , Theodosopoulos Philip , Kunwar Sandeep , Aghi Manish 
Published: December 2020

Abstract

INTRODUCTION
Prolactinomas are common pituitary adenomas managed medically or surgically.

METHODS
Reviewed 181 prolactinomas resected transsphenoidally 2012-2019. Tumor volumes were quantified using BrainLab Smartbrush. Pearson correlation analysis and linear regression were used to identify associations between tumor volumes and serum prolactin. Tumor density was defined as serum prolactin divided by tumor volume.

RESULTS
Mean tumor volume was 6.33cm3 and mean pre-op prolactin was 803.4ug/L, with men having larger (12.11 vs 2.93cm3;p&lt; 0.001) and women having denser (173.9 vs 107.6ug/L/cm3;p=0.011) prolactinomas. Pearson correlation (R=0.688;p&lt; 0.001) and linear regression revealed a strong association between pre-op volume and prolactin levels, with 96.9g/L increase in prolactin/cm3 increase in volume (p&lt; 0.001); this holds true for men (R=0.584;p&lt; 0.001) and women (R=0.939;p&lt; 0.001), with women demonstrating greater prolactin/cm3 tumor density (186.5 vs 75.0ug/L;p&lt; 0.001). MiB index did not correlate with pre-op volume (p=0.449) or pre-op prolactin (p=0.452). Logistic regression showed decreased biochemical remission with increasing pre-op volume (OR=0.891;p&lt; 0.001). Increased MiB index (p=0.971) and p53 (p=0.525) staining did not affect remission rates. Positive PIT-1 staining was associated with higher remission rates (OR=2.508;p=0.005). Patients without remission had denser tumors (149.9 vs. 100.6ug/L/cm3;p=0.013), with Pearson correlation yielding R=0.736 between pre-op volume and pre-op prolactin (p&lt; 0.001), and R=0.476 between residual volume and post-op prolactin (p&lt; 0.001). Patients without remission exhibited 142.9ug/L increase in prolactin/cm3 of pre-op volume (p&lt; 0.001), higher than the 58.9ug/L increase in prolactin/cm3 in patients with remission (p&lt; 0.001). Patients without remission had residual tumors with 68.4ug/L increase in prolactin/cm3 of remaining volume after resection (p&lt; 0.001).

CONCLUSION
Our analysis revealed significant correlation between prolactinoma volume and serum prolactin levels. Patients without remission had greater tumor cellular density than those with remission. The volume-prolactin correlation persisted post-operatively, although surgery reduced tumor density. These results could identify prolactinomas for which surgery could achieve biochemical remission.
NCOG-55. HARMONIZING LANGUAGE TO MAXIMIZE IMPACT: AN UPDATE ON COMMON DATA ELEMENTS FOR MENINGIOMA AND REVIEW OF CLINICAL TRIALS IN MENINGIOMA
Authors: Wang Justin , Nassiri Farshad , Au Karolyn , Drummond Kate , Jenkinson Michael , Santarius Thomas , Barnholtz-Sloan Jill S , Jungk Christine , DiMeco Francesco , Galanis Evanthia , Saladino Andrea , Zhou Yueren , Suppiah Suganth , Badhiwala Jetan , Aldape Kenneth , Poisson Laila M , Zadeh Gelareh 
Published: December 2020

Abstract

BACKGROUND
With increasing studies reporting on the molecular profiling of meningiomas, there is a need to harmonize language used to capture clinical data across centers to ensure that molecular alterations are appropriately linked to clinical variables of interest. Here the International Consortium on Meningiomas presents a final set of core and supplemental meningioma-specific Common Data Elements (CDEs) to facilitate comparative and pooled analyses.

METHODS
The generation of CDEs followed the four-phase process similar to other National Institute of Neurological Disorders and Stroke (NINDS) CDE projects: development/discovery based on data from published and ongoing meningioma trials, internal validation, external validation including presentation of our data form at the Society for Neuro-Oncology previously, and distribution.

RESULTS
We developed a set of CDEs organized into patient- and tumor-level modules. In total, the Consortium identified 16 core CDEs (9 patient-level and 7-tumour-level) e.g. age at index surgery, diagnosis of neurofibromatosis, prior chemotherapy or radiation, tumor location, extent of resection, recurrence, etc. An additional 15 supplemental CDEs were defined and described (8 patient-level and 7 tumour-level) e.g. race, cause of death, multiple tumors, tumor size, Simpson grade, second intervention, etc. These CDES are now made publicly available for dissemination and adoption. We also present a narrative review and analysis of recent and ongoing meningioma trials.

CONCLUSIONS
These CDEs provide a framework for discussion in the neuro-oncology community that will facilitating data sharing for collaborative research projects and aid in developing a common language for comparative and pooled analyses. The CDEs are intended to be dynamic parameters that evolve with time and The Consortium welcomes international feedback for further refinement and implementation of these CDEs.
NCOG-62. CNS SARCOMA IN A TODDLER WITH NOVEL BALANCED TRANSLOCATION OF t(8;11)(q13;q13)
Authors: Patil Prabhumallikarjun 
Published: December 2020

Abstract

A CASE REPORT
A 23-month-old boy was noted to have a brain tumor after being evaluated for chronic global developmental delay. The initial neurological exam was concerning for left leg circumduction and drag. Further investigation with MRI demonstrated a 7 x 9.3 x 7.4 cm supratentorial cystic encapsulated mass identified in the right lateral ventricle with heterogeneously enhancing mural nodule measuring 0.9 x 2.7 x 3.3 cm in diameter. Capsular enhancement was also noted after contrast administration. No diffusion restriction was seen. Mass effect on septum pellucidum was seen along with an increase in size of the left lateral ventricle. Following which the patient underwent right posterior parietal craniotomy and gross total resection of the tumor. Pathology report based on the cellular appearance, cell density, presence of necrosis, and the proliferative activity classified the tumor as likely intermediate grade undifferentiated sarcoma, mostly mesenchymal in origin. Tumor cytogenetics showed balanced translocation (8;11) (q13; q13) in all metaphase cells. Cytogenetics performed on the blood sample showed normal karyotype, suggesting that the translocation seen in tumor cells was somatic in nature rather and not a germline mutation. As the radiological signs and the long clinical course of the disease (evidenced by global developmental delay noted more than a year prior to a presentation and no signs of disseminated disease) suggested it to be a low-grade tumor a decision was made not to treat aggressively with further chemo and radiotherapy. However, the pathology of the tumor was suggestive of a primary malignant undifferentiated sarcoma of the brain. The patient continued to do well with no signs of recurrence on MRI and/or clinical picture for 4 years after the initial surgery.

DISCUSSION
Primary CNS sarcoma is rare. Balanced translocation (8;11) (q13; q13) has not been described in the literature before.
NCOG-65. MR-GUIDED LASER INTERSTITIAL THERMAL THERAPY FOR BRAIN TUMORS IN GERIATRIC PATIENTS
Authors: Ginalis Elizabeth , Danish Shabbar 
Published: December 2020

Abstract

INTRODUCTION
There is a paucity of studies assessing the use of magnetic resonance-guided laser interstitial thermal therapy (LITT) in the elderly population.

METHODS
Geriatric patients (≥65 years) treated with LITT for intracranial tumors at a single institution from January 2011 to November 2019 were retrospectively identified. We grouped patients into two cohorts: 65-74 years (group 1) and 75 years or older (group 2). Baseline characteristics, operative parameters, postoperative course, and morbidity were recorded.

RESULTS
There were 55 patients who underwent 64 distinct LITT procedures. The majority of tumors (62.5%) treated were recurrent brain metastasis/radiation necrosis. The median hospital length of stay was 1 day, with no significant difference between age groups. Hospital stay was significantly longer in patients who presented with a neurological symptom and in those who experienced a postoperative complication. The majority of patients (68.3%) were discharged to their preoperative accommodation. Rate of discharge to home was not significantly different between age groups. Those discharged to rehabilitation facilities were more likely to have presented with a neurological symptom. Nine patients (14.1%) were found to have acute neurological complications, with nearly all patients showing complete or partial recovery at follow-up. The 30-day postoperative mortality rate was 1.6% (n = 1). The complication and 30-day postoperative mortality rate were not significantly different between age groups.

CONCLUSIONS
LITT can be considered as a minimally invasive and safe neurosurgical procedure for treatment of intracranial tumors in geriatric patients. Careful preoperative preparation and postoperative care is essential as LITT is not without risk. Appropriate patient selection for cranial surgery is essential as neurosurgeons treat an increasing number of elderly patients, but advanced age alone should not exclude patients from LITT.
NCOG-66. IMPLICATION OF D-DIMER IN THE DETECTION OF DEEP VENOUS THROMBOSIS (DVT) /PULMONARY EMBOLISM (PE) IN HIGH GRADE GLIOMA PATIENTS WITHOUT CLASSIC SYMPTOMS OF DVT/PE ON OR OFF AVASTIN TREATMENT
Authors: Jha Ruchika , Ranjan Tulika , Yu Alexander , Wegner Rodney , Karlovits Stephen 
Published: December 2020

Abstract
The incidence of DVT/PE in high grade glioma patients is very high with increased risk of intracranial hemorrhage (ICH) in patients with recent surgery, Avastin and chemotherapy induced thrombocytopenia. We have frequently encountered patients with PE who presented with increased fatigue and somnolence before they developed classic symptoms of PE. It is critical that a high index of suspicion be maintained and patient screened for early detection of PE. A retrospective chart review from June 2015 to May 2020 is being performed on 500 patients with high grade glioma. D-Dimer was used as a screening test for early detection of DVT/PE. Of the 175 patients analyzed 57(32.5 %) patients had DVT/PE, 12 had DVT only and 45 patients had PE with or without DVT. Fatigue which was out of proportion to the expected chemotherapy/radiation side effects was present in 38/45 patients with PE. Classic symptoms of PE were only seen in 10/45 patients. Of 57 patients with DVT/PE with positive D-Dimer 10 asymptomatic patients were on Avastin at the time of diagnosis. The median D Dimer value for 44 positive patients was 2.43 (0.57-23.95).Of the 57 positive patients 52 (91.2%) were treated with full anticoagulation- lovenox (n-35), coumadin (n-8), eliquis (n-7) and xeralto (n-2). The IVC filter was placed in 6 patients.High risk patients were fully anticoagulated for 1-3 months. Patients with resolution of PE/DVT were switched to preventive dose of anticoagulants. Two patients had h/o hypercoagulable disorder. Two patients had symptomatic ICH on lovenox and 1 had asymptomatic sub centimeter ICH on Xeralto. Conclusion- D Dimer is very helpful in the early detection of DVT/PE in high grade glioma patients. Patients with excessive Fatigue and somnolence can be screened for PE using D-Dimer.The D Dimer screening can help with early detection of DVT/PE in patients being treated with Avastin.
NCOG-71. GENOME ASSOCIATIONS WITH NEUROCOGNITIVE OUTCOMES, CEREBRAL MICROBLEEDS (CMBS), AND BRAIN VOLUME AND WHITE MATTER (WM) CHANGES IN PEDIATRIC BRAIN TUMOR SURVIVORS
Authors: Kline Cassie , Stoller Schuyler , Byer Lennox , Edwards Caleb , Prasad Rachna , Torkildson Joseph , Gauvain Karen , Samuel David , Lupo Janine , Morrison Melanie , Tong Elizabeth , Savchuk Solomiia , Valencia Christian Rodrigo Ugaz , Rauschecker Andreas , Rudie Jeffrey , Hoffmann Thomas , Dubal Dena , Fullerton Heather , Mueller Sabine 
Published: December 2020

Abstract

OBJECTIVE
To identify genetic predictors of neurocognition, CMBs, brain volume, and WM changes in pediatric brain tumor survivors.

METHODS
Patients were selected from an existing cohort (RadART) if they had: 1) at least one neurocognitive evaluation using computer-based CogState; 2) available DNA; 3) standard imaging. Candidate gene or genome-wide genotyping was performed on all patients. CMBs were identified using a semi-automated algorithm developed in MATLAB. Volume of T2/FLAIR WM signal abnormality was measured using a semi-automated method based on a convolutional neural network. Brain volume and cortical thickness were measured using FreeSurfer volumetric analysis. Logistic and linear regression were done to compare phenotypes with candidate genotypes. Genome-wide efficient mixed-model analysis was done to compare neurocognition and CMBs. Gene set analysis was done using https://fuma.ctglab.nl/.

RESULTS
APOE4 was a candidate variant associated with non-lobar, larger volume CMBs (p&lt; 0.05). At the GWAS-level (n=225), specific genes trended with visual memory, psychomotor function, and CMB count (p&lt; 5x10-8). Using gene set analyses, there were gene set trends seen with CMB count and psychomotor function. Small sample size and low mutant allele frequency limited reliability of these findings. Preliminary volumetric analysis show reduced volume within the right parietal, medial occipital and inferior temporal lobes with increased cortical thickness in the left occipital and medial parietal lobe in patients carrying the ApoE4 allele. WM signal assessments are ongoing.

CONCLUSION
Genetic markers may be associated with neurocognition, CMBs, brain volume and WM changes in pediatric brain tumor survivors; however, larger cohorts are needed to confirm specific gene relevance.
NCOG-76. BASELINE COGNITIVE ASSESSMENT IN GLIOMA PATIENTS WITH MGMT PROMOTOR METHYLATION AND/OR 1p19q CODELETION
Authors: Park Sydney , Giles Abigail , Liberatore Grace , Morgan Katherine , DeBruhl Cynthia , Hsu Fang-Chi , Cramer Christina , Strowd Roy , Chan Michael , Lesser Glenn , Laxton Adrian , Tatter Stephen , Cummings Tiffany 
Published: December 2020

Abstract

INTRODUCTION
Methylguanine methyltransferase (MGMT) methylation status is associated with better overall survival while 1p19q co-deletion is associated with long-term survival. Cognitive dysfunction is a common complication of brain tumors and treatment; however, information regarding the relationship between MGMT status, 1p19q codeletion, and cognition is limited.

METHOD
Baseline neuropsychological testing was performed in patients with malignant glioma prior to radiation and/or chemotherapy administration. A retrospective data analysis was conducted. We calculated composite and subdomain scores for attention/executive functioning, memory, and language in patients with or without MGMT promotor methylation and/or 1p19q codeletion.

RESULTS
Thirty-eight patients (Age M = 48.73 ± 14.98; 50% female) diagnosed with glioma (29% grade II, 16% grade III, 21% grade IV; Karnofsky Performance Status score (KPS) M = 88.75 ± 14.24) were selected from a retrospective. Memory was marginally significant, such that methylated participants performed better on memory tasks than the unmethylated group (p = .053). Independent samples t-test revealed no significant differences between either marker across the overall cognitive composite (methylated M = 41.35; unmethylated: M = 39.91; p = .955; 1p19q co-deleted: M = 50.94; 1p19q intact: M = 43.66; p = .158) and subdomains attention/executive functioning (p = .585; p = .157) and language (p = .581; p = .765). Logistic regression showed MGMT does not predict cognitive status (p =.052) and there were not enough cases to complete the model with 1p19q.

CONCLUSION
MGMT status may be correlated with baseline cognitive status as MGMT methylated patients had better memory scores than their unmethylated counterparts. We did not find any significant association between the remaining cognitive domains and MGMT or 1p19q although sample size is a significant limitation. These results suggest further assessment of changes in cognition during treatment through serial neuropsychological testing of glioma populations with defined marker status is warranted.