bluuebunny/crossref_metadata_2025_split huggingface dataset:
10207- IMT-4 REAL-WORLD DATA AND IMMUNOHISTOLOGICAL STUDY OF AUTOLOGOUS FORMALIN-FIXED TUMOR VACCINE FOR NEWLY DIAGNOSED GLIOBLASTOMA
Authors: Koriyama Shunichi , Nitta Masayuki , Tsuzuki Shunsuke , Kobayashi Tatsuya , Lyu Wendong , Komori Takashi , Masui Kenta , Kawamata Takakazu , Muragaki Yoshihiro 
Published: November 2024

Abstract

BACKGROUND
Glioblastoma (GBM) is a highly malignant tumor with a poor prognosis despite advances in treatment. At our institution, an autologous formalin-fixed tumor vaccine (AFTV) has been used as postoperative adjuvant therapy in addition to standard temozolomide and chemoradiotherapy. We present real-world data and analyze the correlation between AFTV, molecular markers, and clinical outcomes in newly diagnosed GBM patients.

METHODS
This study included 402 newly diagnosed GBM patients treated at our institution between 2005 and 2021. Patients were divided into AFTV (n = 158) and non-AFTV (n = 244) groups. The AFTV group demonstrated a significantly prolonged median progression-free survival (PFS) of 15.0 months compared to 7.8 months in the non-AFTV group (p&lt;0.01) and a median overall survival (OS) of 31.3 months versus 19.4 months (p&lt;0.01). In the subset of 60 patients who underwent gross total resection (GTR), the PFS was 18.4 months, and the OS reached 42.4 months, showing additional benefits. Among 115 elderly GBM patients, typically considered to have a poor prognosis, the AFTV group showed improved outcomes with a PFS of 14.2 months and OS of 27.3 months (p&lt;0.01). In 131 patients who experienced early recurrent within 6 months, AFTV treatment resulted in an OS of 15.1 months compared to 9.4 months in the non-AFTV group (p&lt;0.01). While no significant difference was observed in IDH-mutation, PDL-1 expression analysis in 53 patients revealed that those without PDL-1 expression had a better response to AFTV, with a median OS of 35.3 months compared to 28.4 months in PDL-1 positive patients.

CONCLUSION
AFTV significantly extends survival in GBM patients, particularly in those with GTR, elderly patients, and early recurrent cases. PDL-1 expression may influence AFTV efficacy, indicating the importance of this marker in ongoing and future clinical trials. Multidisciplinary treatment, including AFTV, offers promising potential for improving patient outcomes.
10046- STMO-4 AWAKE SURGERY WITH INTRAOPERATIVE MRI FOR INSULAR GLIOMA
Authors: Takada Shigeki , Makino Yasuhide , Yamamoto Etsuko , Sano Noritaka , Sawada Masahiro , Tanji Masahiro , Mineharu Yohei , Kikuchi Takayuki , Arakawa Yoshiki 
Published: November 2024

Abstract

BACKGROUND
Surgical resection of insular glioma remains challenging due to the complex functional involvement and the intricate vascularization of the insular lobe. We perform awake surgery with intraoperative MRI for insular glioma. We report the outcome of the surgical treatment for insular gliomas at our hospital.

METHODS
We retrospectively reviewed the records of 27 consecutive patients with insular gliomas who underwent surgical treatment between 2014 and 2024. The extent of resection (EOR), ischemic complication and Karnofsky Performance Status (KPS) at postoperative discharge were analyzed in the awake surgery (AS) group compared to the non-awake surgery (NAS) group.

RESULTS
In 12 cases, basal ganglion was involved (basal ganglionic involvement). Berger-Sanai zone III&IV was the most common site within the insula (10 cases), followed by I, II, III&IV (6 cases). Surgical resection was performed in 24 cases (biopsy in 3 cases). Elective awake surgery: 18 cases (of which 5 were abandoned due to poor arousal); intraoperative MRI: 24 cases. Additional resection after intraoperative MRI review was performed in 10 cases. The followings were studied in 24 cases where surgical resection was performed. In characteristics, basal ganglionic involvement was significantly different (3 patients in AS group and 7 patients in NAS group, p=0.04). The mean EOR was 81.4% in AS group vs. 53.4% in NAS group (p=0.008). Ischemic complication rate on postoperative MRI was 15.4% (2 cases) in AS group and 9.1% (1 case) in NAS group; all of them had no permanent neurological symptoms. The deterioration of KPS at discharge was not found in both groups.

DISCUSSION
The EOR of insular glioma in awake surgery with intraoperative MRI in this study was comparable to previous reports. It was indicated that awake surgery with intraoperative MRI contributes greatly to maximum safe resection for insular glioma.
10222- STMO-16 THE FENCE-POST METHOD WITH BONY SURFACE MATCHING REGISTRATION.
Authors: Sadahiro Hirokazu , Sugimoto Kazutaka , Ishihara Hideyuki 
Published: November 2024

Abstract
Neuronavigation has become an indispensable system for brain tumor surgery, and the fence-post method is useful for removal of intramedullary tumors. However, accurate registration is difficult in the lateral or prone position, and the fence-post method is hesitated. Skull registration is considered to be highly accurate, and we have found a method to perform skull registration with a limited amount of exposed skull. We have found a method to perform skull registration with a limited number of exposed skulls, and we report the results of the fence-post method using this method. from May 2023 to August 2024, patients who underwent the fence-post method in the lateral or supine position were included in the study. The navigation system was a StealthStation S8 (Medtronic), and skull registration was performed from CT. If impossible, a skull section was made in the navigation system according to the surgical site, and registration was performed using the skull localized in the surgical field. We encluded 11 cases, five with glioma and six with metastatic brain tumors. Two cases required a craniotomy larger than 10 cm for temporal lobectomy, and in these cases, skull registration was possible without any special modification. In the other 9 cases, the craniotomy was less than 10 cm, and normal skull registration was not possible, but the skull was limited to the operative field, and the fence-post technique was performed. Three cases of glioma were subtotal, and the others were total resections without complications. If the skull is localized to the operative field and sectioned within the navigation system, skull-based registration will be possible, improving the accuracy of the fence-post method and contributing to the safety of the surgery.
10271- STMO-23 TUMOR RECURRENCE PATTERNS AFTER SURGICAL RESECTION OF INTRACRANIAL LOW-GRADE GLIOMAS
Authors: Muragaki Yoshihiro , Fukuya Yasukazu , Ikuta Soko , Maruyama Takashi , Tsuzuki Shunsuke , Saito Taiichi , Kawamata Takakazu 
Published: November 2024

Abstract

INTRODUCTION
Tumor recurrence patterns after resection of intracranial low-grade gliomas (LGG) generally remain obscured. The objective of the present retrospective study was their multifaceted analysis, evaluation of associated factors, and assessment of impact on prognosis.

METHODS
Study group comprised 81 consecutive adult patients (46 men and 35 women; median age, 37 years) with recurrent diffuse astrocytomas (DA; 51 cases) and oligodendrogliomas (OD; 30 cases). The median length of follow-up after primary surgery was 6.7 years.

RESULTS
Early (within 2 years after primary surgery) and non-early (&gt;2 years after primary surgery) recurrence was noted in 23 (28%) and 58 (72%) cases, respectively. Fast (&lt; 6 months) and slow (&gt;6 months) radiological progression of relapse was noted in 31 (38%) and 48 (59%) cases, respectively. Tumor recurrence was local and non-local in 71 (88%) and 10 (12%) cases, respectively. Recurrence patterns have differed in OD, IDH1-mutant DA, and IDH wild-type DA. Early onset, fast radiological progression, and non-local site of relapse had statistically significant negative impact on overall survival of patients and were often associated with malignant transformation of the tumor (38 cases). However, in subgroup with extent of resection &gt; 90% (56 cases) no differences in recurrence characteristics were found between 3 molecularly defined groups of LGG.

CONCLUSIONS
Recurrence patterns after resection of LGG show significant variability, differ in distinct molecularly defined types of tumors, and demonstrate definitive impact on prognosis. Aggressive resection at the time of primary surgery may result in more favorable characteristics of recurrence at the time of its development.
10039- RT-1 TREATMENT RESULTS OF AVAGAMMA THERAPY FOR RECURRENT GLIOBLASTOMA COMBINED WITH GAMMA KNIFE AND BEVACIZUMAB
Authors: Sato Kenichi , Asanome Taku , Ishida Yuuki , Yoshihara Ryuunosuke , Sugio Hironori , Takanashi Masami , Nakamura Hirohiko 
Published: November 2024

Abstract

PURPOSE
We report the treatment results of AVAgamma therapy combining gamma knife (GK) and bevacizumab (Bev) for recurrent glioblastoma.

SUBJECTS
From August 2013 to July 2024, 68 patients with recurrent glioblastoma treated with AVAgamma therapy as salvage therapy at the time of relapse after initial treatment. When the GK irradiated volume was 15 ml or less, a borderline dose of 20-26 Gy was administered in a single fraction, and when it was greater than that, a borderline dose of 24-30 Gy was administered in 2-5 fractions. The mean therapeutic marginal dose was 24 Gy. Bev was administered 10 mg/kg or 15 mg/kg 1 to 10 times after GK.

METHODS
Median progression-free survival (mPFS) and median survival (mOS) from AVAgamma treatment, and mOS and 5-year survival rate from initial treatment were compared with historical controls (GK group: 30 patients) who received only GK at the time of recurrence.

RESULTS
The mPFS from AVAgamma therapy was 6 months, PFS-6month was 40%, OS-6month was 77%, and mOS was 11 months. The mOS from initial treatment was 25 months, which was prolonged compared to 21 months in the GK group (p=0.05). The 5-year survival rate for recurrent glioblastoma was 5% in the GK group and 22% in the AVAgamma group (p=0.05). The 5-year survival rate for glioblastoma with KPS&gt;70% at recurrence was 0% in the GK group and 27% in the AVAgamma group (p=0.14).

DISCUSSION
Combined use of Bev with GK was considered to provide local control of recurrent lesions and prolong life prognosis in patients with good KPS at the time of recurrence.

CONCLUSION
AVAgamma therapy is thought to prolong the survival of recurrent glioblastoma and play an important role as salvage treatment.
10260- MPC-25 INTEGRATED DIAGNOSIS OF GLIOMA IN KYOTO UNIVERSITY HOSPITAL
Authors: Takeucih Yasuhide , Mineharu Yohei , Arakawa Yoshiki 
Published: November 2024

Abstract
In 2021, WHO classification of tumours of the central nervous system (CNS) was published, which drastically changed the diagnostic approach of the tumors in the CNS. Although the latest classification has gradually become more widespread, it is still not easy to search for genetic mutations at many institutions in Japan, including Kyoto University Hospital (KUHP), and this remains an obstacle to the use of the above classification. At the 40th Brain Tumor Society Meeting held in 2022, we introduced our efforts in the diagnosis of glioma, including: (1) holding preoperative/postoperative clinical, imaging, and pathology conferences, (2) consultation to Kansai Molecular Diagnosis Network for CNS Tumors, (3) submission of specimens for cancer gene panel testing for insurance purposes, and (4) external consultation, DKFZ classification by methylation array analysis, and comprehensive analysis using next-generation sequencers. In our hospital during the 3 years from 2021 to 2023, approximately 140 cases of glioma including recurrence were diagnosed. The results of IDH1 R132H and H3K27M immunostaining and genetic abnormalities were consistent in all cases. On the other hand, some gliomas that were IDH1 R132H negative by immunostaining were reclassified as glioblastoma (n=13) or IDH2 mutant astrocytoma (n=1) based on molecular pathological findings, meaning that the diagnosis obtained from the initial pathological diagnosis may not be the correct one based on the molecular pathological findings. One case could not be classified even after performing (2)-(4) above, and one was found to have novel genetic abnormalities. As many medical institutions face difficulties in brain tumor classification based on the latest WHO classification, we would like to share our approach in this presentation and contribute to the improvement of brain tumor pathology diagnosis in Japan.
10068- NI-4 PREDICTIVE FACTOR OF TUMOR-SHRINKING EFFECTS FROM BEVACIZUMAB IN NEWLY DIAGNOSED AND RECURRENT GLIOBLASTOMAS
Authors: Beppu Takaaki , Sato Yuichi , Uchida Shun , Fujiwara Shunrou , Ogasawara Kuniaki , Akamatsu Yosuke 
Published: November 2024

Abstract

PURPOSE
Even after short-term administration of bevacizumab (Bev) demonstrates dramatically rapid volume reduction of glioblastoma. However, an extent of effect varies among patients. This study aimed to search prediction factors for tumor reduction in contrast-enhanced area (CEA) and peritumoral high intensity on FLAIR after Bev.

METHODS
Thirty patients with untreated primary glioblastoma and 34 patients with recurrent glioblastoma enrolled in this study. The former and latter received one-shot and two-shot Bev, respectively. MRI including arterial spin labeling (ASL) were performed before and after administrating Bev. We calculated tumor reduction rate (1-pre-volume/post-volume %) of CEA and HIA from MRI before and after Bev in each patient. Based on reduction rates, all patients were divided into three groups, Group A, patients with reduction rate more than mean value in both CEA and HIA; Group B, patients with reduction rate more than mean value in either CEA or HIA; Group C, patients with reduction rate more than mean value in neither CEA nor HIA. We compared findings of plausible factors, including volumes of CEA and HIA, tumor locations, presence of central necrosis, and CBFT/N on ASL, between three groups.

RESULTS
The reduction rates of CEA and HIA were 29.2% and 42.2% in untreated primary glioblastoma, and 46.5% and 36.3% in recurrent glioblastoma, respectively. The number of patients assigned into Groups A, B, and C were 9, 12, 9 in primary glioblastoma, and 8, 16, 8 in recurrent glioblastoma, respectively. Among factors, only CBFT/N showed a significant difference between 3 groups in both primary and recurrent glioblastomas in univariate analysis. Multi-variate analysis also showed CBFT/N could be a prediction factor in primary glioblastoma.

CONCLUSION
The present study suggested that CBFT/N becomes a prediction factor for reductions of tumor volumes after short-term administration of Bev in glioblastoma.
10219- NI-18 FUNCTIONAL RESECTION BOUNDARY INDICATED BY THE T2-FLAIR MISMATCH SIGN IN IDH-MUTANT GLIOMAS
Authors: Kinoshita Masashi , Nakajima Riho , Tanaka Shingo , Tamai Sho 
Published: November 2024

Abstract

INTRODUCTION
In IDH-mutant gliomas, the T2-FLAIR mismatch sign is a characteristic imaging marker suggestive of astrocytoma. Recently, it has been reported that IDH-mutant astrocytoma showing this feature have a good prognosis; however, the reason for this is still unclear. In this study, we investigated factors associated with gross-total resection of IDH-mutant gliomas in which awake surgery was performed, and validated the characteristics obtained from T2-FLAIR mismatch sign with results of functional mapping.

METHODS
From 2014 to 2023, 60 patients who underwent awake surgery and were diagnosed with IDH-mutant gliomas (WHO grade 2-3; 22 astrocytoma and 38 oligodendroglioma) were included in this study. T2-FLAIR mismatch sign, gross-total resection (GTR), and the following background factors that might have effects on the extent of resection in previous reports were extracted; primary or recurrent tumor, existence of positive functional mapping on the resection boundary of white matter, laterality and localization of the lesion, histopathological diagnosis, and WHO grading. First, statistical analysis of the relationship between GTR, T2-FLAIR mismatch sign, and background factors was performed using stepwise regression analysis. Second, neuroimaging analysis was performed to determine the spatial relationship between lesions and white matter mapping in cases with T2-FLAIR mismatch sign.

RESULTS
Twenty-six cases had no residual lesion after surgery, nine of which had T2-FLAIR mismatch sign and were diagnosed with astrocytoma. Analysis of GTR and background factors showed that T2-FLAIR mismatch sign (p=0.0043), no positive white matter mapping (p=0.0059), and WHO grade 2 (p=0.0182) were statistically significant factors that contributed to GTR. Furthermore, in 7 of the 9 cases with T2-FLAIR mismatch sign, GTR on postoperative neuroimaging was obtained with positive mappings on the normal white matter as the resection boundary.

CONCLUSION
IDH-mutant gliomas with T2-FLAIR mismatch sign may achieve GTR by awake surgery due to the absence of functional regions within the tumor.
10064- ML-2 CLINICAL CHARACTERISTICS OF NON-COMPLETE RESPONDERS TO MTX-BASED INDUCTION THERAPY IN PATIENTS WITH PRIMARY CNS LYMPHOMA
Authors: Nagane Motoo , Sasaki Nobuyoshi , Saito Kuniaki , Kobayashi Keiichi , Kugasawa Kazuha 
Published: November 2024

Abstract

BACKGROUND
The standard care for primary CNS lymphoma (PCNSL) is high-dose methotrexate (HD-MTX)-based induction therapy including R-MPV followed by consolidation therapy with a high CR/CRu rate. However, non-CR (refractory) patients may face poor prognosis, yet factors predicting response to R-MPV remain unclear. We conducted a retrospective analysis of newly diagnosed PCNSL cases treated with R-MPV at our facility.

METHODS
A total of 107 patients treated with R-MPV between November 2011 and December 2023 were identified. Clinical background factors, molecular pathological findings, the number of R-MPV cycles, dose reductions or drug discontinuations, response rates, PFS, and OS were analyzed.

RESULTS
The median age and KPS were 70 years (range 34-90) and 70 (30-90), respectively. Ocular lesions were present in 11 cases (11%), MYD88 mutations were found in 55 (66%), and 26 (38%) were of the GCB subtype. The median number of R-MPV cycles was 7 (1-8), with dose reduction or drug discontinuation in 75 cases (70%). After R-MPV, CR/CRu were achieved in 84 cases (79%), PR in 15 (14%), SD in 2 (2%), and 6 cases had PD (6%), with a non-CR rate of 21.5%. The median PFS was 87.8 months, with median OS not reached and a 5-year OS rate of 79.5%. The median PFS for CR cases was not reached, while for non-CR cases it was 22.5 months (P&lt;0.001). For cases with or without methotrexate or procarbazine dose reduction/discontinuation, PFS was 42.2 months vs. not reached, respectively. The only factor significantly correlated with CR was the number of cycles (P&lt;0.001), with a particularly significant correlation for 4 or more cycles (P&lt;0.001).

CONCLUSIONS
Fewer number of R-MPV cycles (&lt;4) was significantly associated with non-CR. As non-effective cases might result in early discontinuation, further analysis considering possible confounding factors is necessary.
10242- ML-11 A CASE OF PRIMARY CAVERNOUS SINUS MALIGNANT LYMPHOMA DIAGNOSED BY CRANIAL BIOPSY
Authors: Tamura Takeaki , Nakayama Noriyuki , Ohmura Kazufumi , Yamada Tetsuya , Izumo Tsuyoshi 
Published: November 2024

Abstract

BACKGROUND AND AIMS
Following neuroimaging studies, stereotactic irradiation is frequently utilized to treat cavernous sinus tumors. However, differentiating these tumors presents a significant challenge due to the overlapping imaging characteristics of various benign and malignant conditions, including cavernous hemangiomas, pituitary adenomas, schwannomas, meningiomas, sarcoidosis, and metastatic brain tumors.

PATIENT PRESENTATION
We report a rare case of diffuse large B-cell lymphoma (DLBCL) diagnosed via cranial biopsy of a cavernous sinus tumor. A 57-year-old man presented with a one-month history of diplopia and right-sided facial discomfort. Physical examination revealed right abducens nerve palsy and hypoesthesia in the distribution of the second branch of the right trigeminal nerve. Gadolinium-enhanced magnetic resonance imaging (MRI) demonstrated a homogeneously enhancing mass extending from the right cavernous sinus to the ipsilateral optic nerve canal, Meckel’s space, and foramen ovale. Whole-body computed tomography (CT) revealed no abnormalities. A cranial tumor biopsy was performed via an extradural temporopolar approach, resulting in a histopathological diagnosis of DLBCL.

TREATMENT AND RESULTS
Postoperatively, the patient underwent treatment with R-MPV (rituximab, methotrexate, vincristine, and procarbazine), pola-R-CHP (polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisolone), and methotrexate infusion. Two months post-treatment, MRI revealed a reduction in the mass lesion, accompanied by improvements in both diplopia and trigeminal neuralgia.

INTERPRETATION
Primary malignant lymphoma of the cavernous sinus is characterized by a poor prognosis, with overall survival typically limited to a few months. Patients commonly present with facial pain and ocular motility disturbances. The lack of distinctive imaging findings complicates preoperative diagnosis. Although rare, primary malignant lymphomas should be included in the differential diagnosis of cavernous sinus tumors. Accurate histopathological diagnosis of these tumors is crucial for determining appropriate treatment regimens.
10291- ML-17 EXPRESSION OF ICAM-1,INTEGRINΒ1 IN INTRAVASCULAR LARGE B-CELL LYMPHOMA WITH CNS
Authors: Yoshitake Hidenobu , Negoto Tetsuya , Hashimoto Aya , Moritsubo Mayuko , Furuta Takuya , Sakata Kiyohiko , Nakamura Hideo , Morioka Motohiro 
Published: November 2024

Abstract

BACKGROUND
Intravascular lymphoma (IVLBCL) is generally characterized by growth within the microvasculature of extralymphatic organs and lack of invasion into the vessel wall or extravascular space. We experienced a case of concomitant intracranial DLBCL without IVL findings during the course of treatment for IVLBCL. Such cases are rare but have been reported in the past, and the origin of the tumor and the mechanism of metastasis are unknown. We investigated pathologically the deletion of cell adhesion molecules (ICAM-1, integrinβ1), which is considered to be a characteristic feature of IVLBCL, in this case.

METHODS
Among the cases treated at our hospital, 2 cases developed central nervous system intravascular lymphoma (CNS-IVL) after developing IVLBCL, 1 case developed CNS-IVL and subsequently relapsed cutaneous IVL, and 20 other PCNSL cases that followed the usual course of the disease were examined for ICAM-1 and integrinβ1 The histological characteristics of the 20 PCNSL cases were examined by immunostaining for ICAM-1 and integrinβ1.

RESULTS
In normal PCNSL, ICAM-1 and integrinβ1 were strongly expressed around blood vessels and tumor cells, and were absent in areas diffusely infiltrated into the brain parenchyma. In contrast, ICAM-1 and integrinβ1 in tumor cells were generally absent in patients with concomitant IVLBCL.

DISCUSSION
Deletion of cell adhesion molecules in IVLBCL is considered to be a factor that prevents invasion of vascular endothelium and loss of migration to lymph nodes. Interestingly, even in PCNSLs without evidence of IVL, there are areas of weak expression of cell adhesion molecules, suggesting that phenotype may be altered during the invasion process. The amount of specimens obtained from random skin biopsies is often extremely small. Therefore, histological findings will continue to be important.