CNSC-32. CHARACTERISTIC ANALYSIS OF SPREAD AND METASTASIS OF HIGH-GRADE GLIOMA

Abstract OBJECT Exploring the clinical characteristics of spread and metastasis of high-grade glioma is helpful for clinicians to further understand high-grade glioma, optimize clinical decision-making, and make treatment plans. METHOD Clinical data of patients diagnosed with WHO Grade 4 glioma with spread and metastasis in the course of disease in Guangdong Sanjiu Brain Hospital from January 1, 2017 to December 31, 2020 were collected and analyzed. RESULTS 93 patients were included in the analysis, 59 males and 34 females, median age of 42 years (3-71 years). Tumors were located supratentorial in 78 patients (83.9%). Most patients (70, 75.3%) had tumors adjacent to the ventricular system. 28 patients (30.1%) had tumor spread at first diagnosis. All patients received surgical at first diagnosis, including total resection in 36 cases (38.7%), partial resection in 42 cases (45.2%), and biopsy in 15 cases (16.1%). In 48 patients (51.6%), ventricles were opened during operation. 69 cases (74.2%) were pathologically diagnosed with glioblastoma, 81 cases (92.0%) were IDH wild-type. MRI findings of dissemination were linear in 50.0% (46 cases), nodular type in 25.0% (23 cases), mixed type in 25.0% (23 cases), and the remaining 1 case was undetermined. Cerebrospinal fluid examination was performed in 37 cases, which 11 cases were cytological positive (29.7%). Median OS for patients with initial dissemination was 338 days. Of the 68 patients developed transmission after treatment, median OS fro initial diagnosis to transmission was 254 days, the overall median OS was 409 days. The overall median OS for all patients was 403 days. The median OS of newly diagnosed patients with tumor spread was lower than that of patients with tumor spread after treatment, but there was no statistical difference (p=0.05). CONCLUSION Most high-grade glioma patients develop tumor spread within 1 year, and these patients have unique clinical characteristics. The positive rate of cerebrospinal fluid tumor cells is low, MRI imaging is still the main diagnostic option.