bluuebunny/crossref_metadata_2025_split huggingface dataset:
P19.04.B CHROMOGRANIN A IN HUMAN MENINGIOMAS
Authors: Tollefsen S E , Solheim O , Mjønes P , Torp S H 
Published: October 2024

Abstract

BACKGROUND
Meningiomas are the most common intracranial tumor. The neoplasms are usually benign and slow-growing, but the recurrence rates are substantial. There is currently no established pharmaceutical treatment for patients suffering from meningioma, marking the need for a further understanding of tumor biology and investigation of treatment options. Somatostatin receptors are well-known to be present in human meningiomas and somatostatin analogs are investigated as a potential targeted treatment. The presence of somatostatin receptors may suggest a possible expression of other neuroendocrine proteins in human meningiomas. The neuroendocrine glycoprotein chromogranin A is a precursor for several biologically active peptides and contributes to the intracellular formation of secretory granules. Chromogranin A is a well-established neuroendocrine differentiation marker. To our knowledge the immunohistochemical expression of chromogranin A in human meningiomas is not previously investigated. The aim of this study was to investigate neuroendocrine differentiation in human meningiomas by using chromogranin A as an immunohistochemical marker.

MATERIAL AND METHODS
The immunohistochemical expression of chromogranin A were measured in tissue specimens from 162 patients operated for primary World Health Organization 2016 classification grade 1 or 2 meningioma in the period of 1991 to 2000 at St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Sections were incubated for 40 minutes in room temperature with a monoclonal chromogranin A antibody (clone DAK-A3, dilution 1:100).

RESULTS
None of the 162 tissue specimens of meningioma were immunoreactive for chromogranin A.

CONCLUSION
Chromogranin A was not immunohistochemically expressed in our series of 162 meningioma specimens, thus not supporting neuroendocrine differentiation in human meningiomas. However, as other neuroendocrine peptides (such as somatostatin receptors) are previously detected in meningiomas, further investigations are needed to conclude on the matter of neuroendocrine differentiation in meningiomas.
P19.05.B CHROMOSOME 1P DELETION IS A NEGATIVE, INDEPENDENT, PROGNOSTIC FACTOR IN ATYPICAL MENINGIOMAS
Authors: Mulone D , Pedron S , Alberti S , Zanconato G , Caffo M , Barresi V 
Published: October 2024

Abstract

BACKGROUND
The treatment of patients with meningiomas is based on the degree of surgical excision and the tumor histological grade, which is determined according to the World Health Organization (WHO) classification of tumors of the central nervous system (CNS). Meningiomas are classified into three grades of malignancy, based on the presence of histopathological and molecular features. Grade 1 meningiomas do not require adjuvant treatment, while grade 3 tumors are generally treated with radiotherapy. For grade 2 meningiomas, which have a 50% 5-year recurrence-free survival rate and an uncertain prognosis, both radiotherapy and observation have been proposed. Consequently, identifying molecular factors that can predict the recurrence risk of grade 2 meningiomas and detect cases requiring adjuvant treatment has been a significant research issue in recent years. Several studies have found that chromosomal copy number variations, particularly the deletion of chromosome 1p, may be prognostically relevant in meningiomas. In this study, we examined 1p deletion in 79 grade 2 meningiomas of the atypical subtype and its correlation with clinico-pathological features and molecular group.

MATERIAL AND METHODS
Using Fluorescent In Situ Hybridization (FISH) and 1p36/1q25 dual color FISH probes, we analyzed 1p chromosome deletion in 79 meningiomas, which were histologically classified as atypical subtype and treated with gross total resection. Cases were classified as “1p deleted” when at least 50% of the nuclei had one signal for 1p and 2 signals for 1q. Data on recurrence-free survival (RFS) were available in 70 meningiomas. Molecular groups (MGs) were established using immunohistochemistry for MCM2 and ACADL as surrogates for proliferative and hypermetabolic MGs. Kaplan-Meier curves and the Mantel-Cox log-rank test were used to evaluate the association between 1p deletion and other clinical-pathological or molecular parameters and RFS. A chi-squared test was utilized to investigate correlations between 1p deletion and clinical-pathological features.

RESULTS
Chi-squared test revealed that 1p deletion was significantly associated with proliferative and hypermetabolic MG (P= 0.0128), mitotic index ≥6/1.6 mm2 (P= 0.0101), presence of necrosis (P= 0.0076) and recurrence (P= 0.0072). In addition, chromosome 1p deletion was significantly associated with a shorter RFS (P= 0.0196), and was an independent negative prognostic variable (P= 0.0159), along with necrosis (P= 0.0006) in multivariate analysis.

CONCLUSION
Chromosome 1p deletion, detected using FISH, is a robust negative prognostic factor, associated with high proliferation, in atypical meningiomas. Therefore, it could be used to identify cases at a higher risk of recurrence and which could benefit of adjuvant treatments.
P20.11.A DIAGNOSTIC DELAY OF PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA (PCNSL) MAY BE CAUSED BY INFLAMMATORY DIFFERENTIAL DIAGNOSES
Authors: Beyer I , Proescholdt M , Wiesinger I , Bumes E , Haedenkamp T , Fischl A , Lee D , Koelbl O , Schmidt N O , Wendl C , Pukrop T , Mayer S , Riemenschneider M J , Linker R , Hau P 
Published: October 2024

Abstract

BACKGROUND
PCNSL is a rare extranodal subtype of B-cell non-Hodgkin lymphoma initially located in the central nervous system. It can only be finally diagnosed with tissue sampling. Therefore, tumor biopsy and staging examinations beforehand can delay diagnosis. Consequently, PCNSL at histological diagnosis has often already evolved for a prolonged time. However, late therapy start may worsen treatment outcomes. A clearer delineation of PCNSL-specific clinical and imaging features that leads to an earlier diagnosis might accelerate start of therapy and improve prognosis. We here performed a retrospective analysis to construct a pathway that enhances this process.

MATERIAL AND METHODS
Clinical and imaging data of patients with histologically confirmed PCNSL diagnosed between 2012 and 2022 and hospitalized in the University Hospital Regensburg, was collected retrospectively from the local clinical management systems and tumor registry. Data included demographic, prognostic and clinical data incl. neurocognitive function (NCF), neuropathological and laboratory data, and magnetic resonance imaging (MRI). Descriptive analyses and univariate and multivariate analyses were performed. Survival data was calculated using the Kaplan Meier-method.

RESULTS
A retrospective cohort of 108 patients was investigated. Median time to diagnosis (TTD) was 40 (range, 6-1,100) days and median time to hospitalization (TTH) was 14 (range, 0-700) days. Median overall survival (OS) was 20 months (range, 0.5-125+). There was no significant correlation between TTD and OS (r= 0.001, p=0.990) nor between TTD and progression free survival (PFS) (r=0.031, p=0.756). However, TTH correlated significantly to TTD (r=0.429, p&lt;0.001). Most common symptoms at incidence were cognitive decline (N=63, 59%) and psychiatric symptoms (N=41, 38%). Together, 6% of patients had positive McDonald criteria that would have defined autoimmune disease. MRI was the diagnostic technique with the greatest variation of differential diagnoses, including primary brain tumors in 44% of patients. Abnormal memory in NCF was detected as risk factor for decreased OS (HR=3.237, CI=1.111-9.434; p=0.023) and increased TTH (partial eta squared=0.279; p=0.024).

CONCLUSION
We conclude from our data that a delayed diagnosis of PCNSL cannot be verified as a causal factor for decreased OS or PFS. The relevance of a delayed diagnosis therefore may be restricted to certain subgroups who show a more dynamic disease. In relation to this hypothesis, the positive correlation of TTH to TTD suggests, that a subgroup of PCNSL may have a less dynamic course leading to a prolonged diagnostic period. Whereas symptoms like cognitive decline and psychiatric symptoms are typical for PCNSL, typical patterns in MRI do not occur and the rate of false negative diagnoses is high.
P22.02.B ACCOMMODATING LIFE DISRUPTION: AN INTERPRETIVE EXPLORATION OF LIVING WITH LOW-GRADE GLIOMA
Authors: Legge D M , Langbecker D , Yates P 
Published: October 2024

Abstract

BACKGROUND
Significant treatment and resource allocation are directed towards improving the support and services for people with high-grade glioma, recognising this diagnosis brings significant care burden and high supportive care needs. People diagnosed with the less common low-grade glioma (LGG) often live for an extended period of time following diagnosis, needing to find ways to manage family, work, health, and relationships. In this study, we explored social processes these people undertake to accommodate a diagnosis of LGG.

MATERIAL AND METHODS
Symbolic interactionism was used as a lens for this work, incorporating Charmaz’s grounded theory methods to identify the social processes undertaken in accommodating LGG. Semi-structured interviews were conducted with adults diagnosed with LGG, purposively selected for their rich contribution to the data. Interviews were audio-recorded and transcribed verbatim. Data analysis occurred concurrently with interviews to enable co-construction of social processes, ensuring the emerging concepts remained grounded in the data. Concepts were confirmed through coding and constant comparison. Data analysis was managed using NVivo v11.4 software.

RESULTS
Interviews were conducted with 13 people with grades 2 and 3 glioma between June and December 2016, lasting a median of 67 (range: 52-82) minutes. Participants were from Australia, rural and urban areas, aged between 21 - 65 years with a median of 4.5 years since diagnosis. A core concept of ‘Accommodating Life Disruption’ emerged with three supporting social processes describing how people dealt with a diagnosis of LGG: 1) Dealing with contradictions; identifying the ambiguous clinical context and the language and narrative used in LGG; 2) Defining time; where LGG marks a point in time, with people taking stock of their resources and values; and 3) Re-negotiating identity; describing how people with LGG take control, make connections and go about creating a good life.

CONCLUSION
This interpretive study highlights the nuanced social processes people undertake to accommodate the diagnosis of LGG and identifies clear targets for improving supportive care resources and survivorship practices for people with LGG. The findings also offer an opportunity to consider and improve how health professionals interact and communicate the diagnosis for people with LGG and their families.
P22.03.A ASSESSING PALLIATIVE CARE APPROACHES IN NEUROONCOLOGY: INSIGHTS FROM GERMANY
Authors: Lawson McLean A , Lawson McLean A , Ernst T , Forster M , Freyschlag C , Gempt J , Goldbrunner R , Grau S , Jungk C , von Oorschot B , Rosahl S , Wedding U , Neumeister A , Senft C , Kamp M 
Published: October 2024

Abstract

BACKGROUND
This study aims to assess the palliative care practices across neurooncology centres in Germany, focusing on the variations in integration, timing, and involvement in tumour board discussions. By pinpointing gaps in care, it seeks to contribute to discussions on refining optimal palliative care strategies.

MATERIAL AND METHODS
Surveys were distributed to both DKG-certified neurooncology centres and non-certified university neurooncology centres in Germany to investigate their palliative care frameworks and practices. The survey examined department availability, participation in tumour boards, timing of integration, and the use of standardised screening tools for assessing palliative burden and psycho-oncological distress.

RESULTS
Out of 57 centres contacted, 46 responded (81% response rate). The findings indicate that 76.1% of centres have dedicated palliative care departments, but only 34.8% include specialists in tumour board discussions. There is notable variability in the initiation of palliative care, with early integration occurring in only 30.4% of centres at the diagnosis stage. The survey also reveals a lack of standardised spiritual care assessments and minimal use of advanced care planning. Discrepancies in documenting and treating palliative care symptoms and social complaints highlight the need for comprehensive care approaches.

CONCLUSION
This study underscores the diverse landscape of palliative care provision within German neurooncology centres and stresses the importance of standardised practices and early integration. It suggests the imperative need for developing standard protocols and guidelines to enhance the quality and uniformity of palliative care, ultimately improving patient-centred care in neurooncology.
P22.14.A REPORTING STANDARDS IN RANDOMIZED CONTROLLED TRIALS WITH FAMILY CAREGIVERS IN NEURO-ONCOLOGY: A SYSTEMATIC REVIEW FROM THE RANO-CARES WORKING GROUP
Authors: Boele F W , Hertler C , Sherwood P , Cachia D , Dirven L , Young J , Walbert T , Stockdill M , Rodriguez Almaraz E , Piil K 
Published: October 2024

Abstract

BACKGROUND
Family caregivers in neuro-oncology consistently report high levels of unmet support needs, yet intervention trials and effective support options are scarce. To raise the standard of caregiver-related research reporting in neuro-oncology, the Response Assessment in Neuro-Oncology (RANO-) Cares working group has been established. We investigated the current state of methodological quality of reporting on neuro-oncology caregiver outcomes in randomized controlled trials (RCTs).

MATERIAL AND METHODS
A systematic literature review (PubMed/Medline, Embase, Web of Science, Emcare, Cochrane Library, PsycINFO; July 2023) was performed to evaluate to what extent RCTs assessing outcomes of family caregivers of adult primary brain tumour patients adhere to minimum reporting standards. Using Covidence, screening and data extraction was done by two researchers independently, with a third guiding consensus. A 33-item checklist (23 applicable to secondary analysis reports) based on the International Society for Quality of Life Research (ISOQOL) criteria for patient-reported outcome (PRO) reporting was used to review each article. Risk of bias was assessed per RCT.

RESULTS
Fifteen publications (12 RCTs) included 684 neuro-oncology caregivers, with low overall risk of bias. Ten publications (66%) reported on caregiver outcomes as a primary aim, of which eight (80%) satisfied ≥2/3 of the key methodological criteria. Of the five secondary analysis reports (33%) two (40%) met ≥2/3 of applicable key criteria. Criteria often not reported adequately included sample size calculations (reported adequately in n=8, 53%), participant flow (n=9, 60%) window for data collection (n=1, 6%), and extent of (n=10, 66%), reasons for (n=9, 60%), and statistical approaches in dealing with (n=4, 26%) missing data. Unpublished outcome measures were seldom supplied as supplementary material (2/12 publications, 16%).

CONCLUSION
Whilst there are opportunities to enhance reporting standards, RCTs that include neuro-oncology caregiver outcomes generally adhere to high quality reporting standards, and have low risk of bias, indicating good potential to impact evidence-based, clinical practice.
P23.07.B POSTOPERATIVE TRAJECTORIES OF SELF-PERCEIVED COGNITIVE FUNCTION AND ASSOCIATED FACTORS IN PATIENTS WITH PRIMARY BRAIN TUMORS
Authors: Butterbrod E , Rutten G , Sitskoorn M , Gehring K 
Published: October 2024

Abstract

BACKGROUND
Cognitive dysfunction profoundly impacts daily lives of patients with brain tumors. Standardized tests are key to its objective assessment, but fail to fully capture patients’ experience of cognitive (dys-)function in day-to-day activities. The way in which this self-perceived cognitive function (SPCF) changes over the disease course is not clear, and limited insights into factors that contribute to SPCF trajectories hinder early risk identification and intervention. This study aimed to identify latent trajectories of SPCF and associated factors in patients with meningioma or glioma.

MATERIAL AND METHODS
Patients with meningioma or glioma reported SPCF through the Cognitive Failures Questionnaire (CFQ) as part of a neuropsychological screening within two weeks before surgery, three months post-surgery and one year post-surgery. A higher CFQ score indicated more severe complaints. An unsupervised latent class growth (LCG) model was used to identify classes of patients based on the longitudinal trajectory of their CFQ scores. For comparative purposes, a second LCG model was applied to longitudinal data with similar intervals from healthy controls (n=158). Diagnosis, sociodemographics, anxiety and depression symptomatology, general and activity-related fatigue, and the presence of cognitive impairment (Z-score &lt;-1.5 on ≥ 1 cognitive test) before surgery were adopted as external predictors of patients’ trajectories, based on proportional classification.

RESULTS
In total, 159 patients (meningioma, n=103; glioma, n=56 [60% IDH-1 mutated]) were included based on availability of ≥2 consecutive CFQ assessments. A four-class LCG model, i.e., four distinct trajectories, showed the best fit among patients. Trajectories were interpreted as follows: a moderate complaint load showing a mild increase across each timepoint (62% of the sample), a low and stable complaint load (20%), a high load with a late increase between 3 and 12 month follow-up (11%) and a low load with a similarly late increase (8%). In controls, three trajectories with low (46%), low-moderate (31%) and moderate (23%) complaint loads existed, all of which showing a mild decrease over time. After false discovery rate correction, pre-surgical general and activity-related fatigue were related to patients’ CFQ trajectories, with stronger fatigue particularly distinguishing the two trajectories with late increases from the others.

CONCLUSION
Patients showed four distinct trajectories of SPCF up to one year after surgery. Trajectories were characterized by different, but mostly increasing, complaint loads. While similar across diagnoses, patients’ trajectories were seemingly different from those of controls. Among early factors, fatigue types seem particularly related to the course of SPCF. Potentially diverse trajectories of domain-specific complaints should be investigated.
P25.02.A GLIOBLASTOMA RESEARCH FROM 1938 TO 2021: INCREASED SURVIVAL, CHANGING TREATMENT REGIMES, AND GENDER DISPARITIES IN AUTHORSHIP
Authors: Breu J , Nenning K , Baumann B , Nam D , Woehrer A 
Published: October 2024

Abstract

BACKGROUND
Glioblastoma is the most common and aggressive malignant brain tumor in adults with continued poor prognosis. While the long-lasting gold standard RT-TMZ was eventually refined by incorporating tumor treating fields as well as lomustine for subsets of patients, patient outcomes showed only modest improvements over the decades. Here, we set out to map patient outcomes according to type of study, treatment approach and publication year. Additionally, we explore geographic origin and sex differences in authorship per study type to track disparities in glioblastoma research.

MATERIAL AND METHODS
We conducted a systematic literature search using the terms “glioblastoma” AND “overall survival” at PubMed.gov. We manually reviewed 20,047 articles from 1938 to 2021 and included 2,232 ones that reported median overall survival for human subjects. Study type was categorized as case series, clinical trials (CTs), randomized controlled trials (RCTs), meta-analysis and population-based studies. For each study, treatment, number of subjects, and authorship details were extracted.

RESULTS
65.5% of articles were case series followed by 23.9% CTs. Overall, median OS was 13.1 months for all studies and increased from 11.3 months in 1938-2000 to 14.3 months in 2001-2021. Population-based studies reported the lowest median OS (9.0 months). Survival increases were similar for studies reporting radiotherapy (r=0.32), chemotherapy (r=0.27) and temozolomide (r=0.20). No significant survival increases were observed in studies reporting targeted therapies (r=0.22), tumor treating fields (r=0.23), bevacizumab (r=0.02) and immunotherapies (r=-0.10). Despite making up only 5.6% of all studies, RCTs had the highest cumulative impact factor and citation count. While US-based researchers dominated across all study types, 25.2% of articles were authored by females as first and 18.5% as last authors. Only for meta analysis, gender parity seemed to be achieved in first authorship (46.2% female first). Women continued to be under-represented, particularly as last authors in range from 15.4% to 22.5% across study types.

CONCLUSION
Almost 100 years of reported survival of patients with glioblastoma document a consistent, but slow increase in survival, with overly optimistic survival reported in non-population-based studies. Research by women as first authors shows an upward trend, although gender equality has not been achieved yet, particularly in last authorship.
P27.08.B EVALUATING THE SURVIVAL OUTCOMES OF REPEAT SURGICAL RESECTIONS FOR RECURRENT PRIMARY BRAIN TUMOURS: A RETROSPECTIVE ANALYSIS
Authors: choudhury M , Harris L , Sioftanos G , Vaqas B 
Published: October 2024

Abstract

BACKGROUND
Primary brain tumours (PBTs), particularly Glioblastoma Multiforme (GBM), are known for their aggressive nature and poor prognosis. This study evaluates the survival outcomes of patients undergoing repeat resections for PBTs at a tertiary neurosurgical centre.

MATERIAL AND METHODS
We conducted a retrospective analysis of consecutive cases of repeat surgical resections for PBTs from January 2000 to August 2022. Data included patient demographics, initial and subsequent treatments, and survival times up to August 31, 2023. Kaplan-Meier estimates were used to analyse survival rates and progression times from both initial and repeat surgeries.

RESULTS
The median follow-up (FUP) was 72.5 months. During this period 18 patients had a repeat resection (RR). 61% (11) were male. 10, 3 and 5 patients had confirmed GBM, G3 and G2 astrocytoma respectively. Postoperatively, 8/10 GBM patients completed 60Gy in 30 of concurrent chemo-radiotherapy (CRT) and one received 40Gy in 15 alone. 1 GBM patient was deemed too frail for Radiotherapy (RT). 8/10 went on to receive Temozolomide (TMZ). 5/10 of these had a positive MGMT status (&gt;1-25%). The median time on TMZ before progression was 6 months. All G3 patients and 3/5 G2 patients completed postoperative RT following initial surgery. Median progression time following initial surgery was 12 months (IQR: 8.5), 97 months (IQR: 29.5) and 95 months (IQR: 45) for GBM, G3 and G2 astrocytoma respectively. The median time between initial and repeat resection (RR) was 13, 98 and 95 months for GBM, G3 and G2 astrocytoma respectively. Following RR one G3 and G2 cases was upgraded to a GBM and G3 diagnosis. 7/10 GBM and all G3 patients were fit enough to receive further chemotherapy following RR. 2/5 G2 patients who were RT naive received RT with receiving further chemotherapy post-RR. During the FUP period 7/10, 2/3, 2/5 GBM, G3, G2 patients died. Median OS from initial surgery was 21, 181 and 97 months with Median OS from RR 8, 85 and 29 months for GBM, G3 and G2 astrocytoma respectively.

CONCLUSION
Repeat resections may provide a survival benefit in a highly selective group of patients, particularly in the GBM cohort, where outcomes were favourable compared to published real-world population data. Repeat surgical resection is well-tolerated and could be considered as part of the management strategy for recurrent PBTs, especially in the context of prolonged survival observed in G3 and G2 astrocytoma cases.