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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Risk factors of extraneural spreading in astrocytomas and oligodendrogliomas in donors with gliomas: A systematic review
Serena Ammendola, Valeria Barresi, Elena Bariani, Ilaria Girolami, Antonia D’Errico, Matteo Brunelli, Massimo Cardillo, Letizia Lombardini, Amedeo Carraro, Ugo Boggi, Owen Cain, Desley Neil, Albino Eccher
Serena Ammendola, Valeria Barresi, Elena Bariani, Matteo Brunelli, Section of Pathology, Department of Diagnostics and Public Health, University of Verona, Verona 37134, Italy
Ilaria Girolami, Division of Pathology, Central Hospital, Bolzano 39100, Italy
Antonia D’Errico, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna 40138, Italy
Massimo Cardillo, Letizia Lombardini, National Transplant Center, Istituto Superiore di Sanità, Rome 00161, Italy
Amedeo Carraro, General Surgery and Liver Transplant Unit, Verona University Hospital, Verona 37126, Italy
Ugo Boggi, Division of General and Transplant Surgery, Pisa University Hospital, Pisa 56126, Italy
Owen Cain, Desley Neil, Department of Cellular Pathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, United Kingdom
Albino Eccher, Department of Pathology and Diagnostics, Verona University Hospital, Verona 37126, Italy
Author contributions: Ammendola S, Eccher A, Bariani E, Girolami I, Barresi V, Brunelli M, Boggi U, Cardillo M, and Carraro A performed the review and editing of manuscript; Ammendola S, Eccher A, Bariani E, Girolami I, and Barresi V performed the conceptualization; Ammendola S, Eccher A, Bariani E, and Girolami I performed data curation and investigation; Bariani E, Girolami I, Barresi V, Brunelli M, Boggi U, Cardillo M, Carraro A, D’Errico A, and Lombardini L performed the visualization; Ammendola S and Eccher A performed formal analysis, methodology, and preparation of the original draft; Neil D and Cain O performed the review and language editing of the manuscript; and all authors had access to the data, played a role in writing, and agreed to the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2020 Checklist, and the manuscript was prepared and revised according to the PRISMA 2020 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Serena Ammendola, MD, Doctor, Section of Pathology, Department of Diagnostics and Public Health, University of Verona, P.le L.A. Scuro 10, Verona 37134, Italy.
serena.ammendola88@gmail.com
Received: January 7, 2022
Peer-review started: January 7, 2022
First decision: February 21, 2022
Revised: February 25, 2022
Accepted: May 22, 2022
Article in press: May 22, 2022
Published online: June 18, 2022
Processing time: 158 Days and 21.1 Hours
BACKGROUND
Patients with a history of primary brain tumors can be eligible for organ donation under extended criteria. The risk assessment of tumor transmission via organ transplant in primary brain tumors is primarily based on the assessment of tumor histotype and grade. Previous surgeries, chemo-/radiotherapy, and ventriculo-peritoneal shunt placement can lead to a disruption of the blood-brain barrier, concurring to an increase in the transmission risk.
AIM
To investigate the role of tumor transmission risk factors in donors with oligodendrogliomas and astrocytomas.
METHODS
We searched PubMed and EMBASE databases for studies reporting extraneural spreading of oligodendrogliomas and astrocytomas and extracted clinical-pathological data on the primary tumor histotype and grade, the elapsed time from the diagnosis to the onset of metastases, sites and number of metastases, prior surgeries, prior radiotherapy and/or chemotherapy, ventriculo-atrial or ventriculo-peritoneal shunt placement, and the presence of isocitrate dehydrogenase 1/2 mutation and 1p/19q codeletion. Statistical analysis was performed using R software. Statistical correlation between chemotherapy or radiotherapy and the presence of multiple extra-central nervous system metastases was analyzed using χ2 and Fischer exact test. The Kaplan-Meier method was used to evaluate the presence of a correlation between the metastasis-free time and: (1) Localization of metastases; (2) The occurrence of intracranial recurrences; and (3) The occurrence of multiple metastases.
RESULTS
Data on a total of 157 patients were retrieved. The time from the initial diagnosis to metastatic spread ranged from 0 to 325 mo in patients with oligodendrogliomas and 0 to 267 mo in those with astrocytomas. Respectively, 19% and 39% of patients with oligodendroglioma and astrocytoma did not receive any adjuvant therapy. The most frequent metastatic sites were bone, bone marrow, and lymph nodes. The lungs and the liver were the most commonly involved visceral sites. There was no significant correlation between the occurrence of multiple metastases and the administration of adjuvant chemo-/radiotherapy. Patients who developed intracranial recurrences/metastases had a significantly longer extraneural metastasis-free time compared to those who developed extraneural metastases in the absence of any intra- central nervous system spread.
CONCLUSION
A long follow-up time does not exclude the presence of extraneural metastases. Therefore, targeted imaging of bones and cervical lymph nodes may improve safety in the management of these donors.
Core Tip: Recognized risk factors of tumor transmission from donors with a history of primary brain tumors are previous surgery, chemotherapy,and radiotherapy. We performed a systematic review of the literature on oligodendroglioma and astrocytomas with extraneural metastases, aiming to clarify the role of tumor transmission risk factors. We searched PubMed and EMBASE databases for studies reporting extraneural spreading of these gliomas. Performed treatments do not seem to impact on the timing of metastatic spread, and a long follow-up time does not exclude extraneural spread. Targeted imaging of bones and cervical lymph nodes may improve safety in the management of these donors.
