Published online Jun 18, 2022. doi: 10.5500/wjt.v12.i6.131
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
Under extended criteria, patients with a history of primary brain tumor can be eligible for organ donation. Tumor histotype and tumor grade are considered the main risk factors of tumor transmission, and previous surgeries, chemo-/radiotherapy, and ventriculo-peritoneal shunt placement concur to increase the transmission risk.
Most of the literature on the extraneural metastatic spread of diffuse gliomas is based on case reports and case series, and there is a lack of systematic appraisal of patterns of metastatic spread- and on factors concurring to increase the risk of extraneural spreading.
We aimed to collect and analyze the existing literature on extraneural spreading of oligodendroglial and astrocytic tumors in order to identify clinical or pathological factors that could help clinicians to assess the risk of tumor transmission from donors with a history of these gliomas and guide decision making in organ transplantation.
We performed a systematic review of the literature in accordance with the PRISMA guidelines. A literature search without language restrictions was performed in the electronic databases MEDLINE-PubMed and EMBASE, searching for articles, case reports, and case series reporting data on extra-central nervous system metastases of oligodendrogliomas and astrocytomas.
Elapsed time from the initial diagnosis to metastatic spread ranged from 0 to 325 mo and from 0 to 276 mo for oligodendrogliomas and astrocytic tumors, respectively. The most common metastatic sites were bone and lymph nodes for both tumors, while the most common visceral sites were the lungs and the liver in patients with oligodendrogliomas and lungs, liver, and kidneys in patients with astrocytomas. Among patients with astrocytomas, 7 did not undergo surgery, chemo-/radiotherapy or ventriculo-peritoneal shunt placement before the onset of metastases.
A long interval between the tumor diagnosis and the donor’s death does not exclude the possibility of extraneural spreading of these tumors. Bone and lymph nodes are the most common metastatic sites; the lungs and the liver are instead the preferential visceral sites of metastatic spread. Follow-up imaging of the skeleton and cervical lymph nodes could be useful to identify metastatic disease in donors with a history of these gliomas.
The diagnostic advances made recently in tumor classification and targeted follow-up protocols could improve the knowledge on the factors involved in extraneural spreading of gliomas, with repercussions on the tumor transmission risk assessment of potential donors.