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Butterfly gliomas: a time for stratified management?
Siddharth Sinha1, Adam Avnon2, Andrea Perera2,3
1Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK. siddharth.sinha@nhs.net.
Neurosurgical Review
|September 4, 2023
Summary
Butterfly glioblastomas (bGBM) have a poor prognosis. Conservative management is recommended unless patients receive dual adjuvant chemoradiotherapy after biopsy or resection, which significantly improves survival.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Oncology
Background:
- Butterfly glioblastomas (bGBM) are rare WHO grade IV tumors with a poor prognosis.
- Debate exists regarding the impact of diagnosis and intervention on bGBM progression.
- High-volume center experience is reviewed to evaluate management and outcomes.
Purpose of the Study:
- To evaluate management decisions and outcomes for butterfly glioblastomas.
- To determine factors influencing survival in bGBM patients.
Main Methods:
- Retrospective analysis of 80 bGBM cases (January 2009 to June 2021).
- Assessment of demographics, presentation, tumor characteristics, management, and survival.
- Statistical analysis included Kaplan-Meier, log-rank, and Cox proportional hazard models.
Main Results:
- No significant survival difference between conservative management and single adjuvant therapy (p=0.69).
- Dual adjuvant chemoradiotherapy post-biopsy/resection significantly increased survival (p=0.002).
- Oncology treatment significantly impacted survival; age and KPS did not.
Conclusions:
- Butterfly glioblastomas have a poor prognosis.
- Conservative management is advised unless dual adjuvant chemoradiotherapy is planned post-biopsy/resection.
- Avoid unnecessary procedures to mitigate morbidity and costs.
