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Sarcoma Biology & 'Omics

(P 423) PRIMARY GLIOSARCOMA; IMPACT OF ADJUVANT CHEMO(RADIO)THERAPY ON SURVIVAL OUTCOME

Location: The Liffey, Level 1
Objective: Gliosarcoma is a rare very aggressive tumor affecting the brain and the central nervous system. It has high mortality rates. Multimodality treatment is recommended including Subtotal or total tumor resection with adjuvant chemotherapy or radiotherapy. The impact of adjuvant therapy is controversial So, this study aims to assess the impact of adjuvant therapy on survival outcome.

Methods: We extracted the data of 780 patients from Surveillance, Epidemiological, and End Results (SEER) database diagnosed from 2000-2019. We assigned the patients into 4 subgroups; surgery with no adjuvant therapy, adjuvant chemotherapy, adjuvant radiotherapy, adjuvant combined chemoradiotherapy. Surgeries included were: Tumor destruction, Local excision of the tumor both total and subtotal excision, Radical total gross resection of tumor, and gross total resection of lobe of brain (lobectomy). We used SPSS 25 for data analysis, performed Kaplan-Meier and log rank test for survival analysis.

Results: The overall 3 years and 5-year survival is 10.3% and 5.9%. the 5-year relative survival for adjuvant chemotherapy, adjuvant chemoradiotherapy, adjuvant radiotherapy and surgery with no systemic therapy (10.2%,7.9%,2.2 % and 0.8% respectively; P< 0.0001). Out of 780 patients, 61.8% were males while females represented 38.2%. Kaplan Meier analysis stratified by gender showed significant impact (P < 0.0001).

Conclusion: Gliosarcoma has poor 3-year and 5-year Survival outcome in all subgroups. Adjuvant chemotherapy shows quite similar 5-year survival outcome for combined adjuvant chemoradiotherapy while adjuvant radiotherapy and surgery with no systemic therapy had the worst survival outcome. The current guidelines recommend combined adjuvant modality for gliosarcoma management, however our results find no survival benefit for adjuvant radiotherapy. Therefore, we can avoid unnecessary serious side effects of radiotherapy for better post treatment quality of life.