• Andrea Rigamonti, Giorgia Simonetti, Antonio Silvani, Roberta Rudà, Federica Franchino, Veronica Villani, Andrea Pace, Rossella Merli, Maura Servida, Alberto Picca, Giulia Berzero, Alfonso Cerase, Ivano Chiarotti, Giannantonio Spena, Andrea Salmaggi, and neurooncology group of SNO (Society of Hospital Neurosciences, Italy).
• Neurosciences Department, Neurology Unit, Ospedale A. Manzoni, ASST Lecco, Via Dell'Eremo 9/11, 23900, Lecco, Italy. rig74@libero.it.
• Neurol. Sci. 2021 May 1; 42 (5): 1879-1886.

Background And PurposeAdult brainstem gliomas are rare primary brain tumours with heterogeneous clinical course. The low frequency of these tumours makes it difficult to achieve high-quality evidence regarding prognostic factors, adequate therapeutic approach and outcome in such patients.MethodsIn this retrospective study, we analysed clinical, radiological, molecular, prognostic and therapeutic factors in a series of 47 histologically proven adult brainstem gliomas recruited over a 20-year period (1998-2018).ResultsTwenty-two patients were male, 25 female with median age of 39 years. The tumour involved one brainstem segment in 20 cases and 2 or more segments in 27. Contrast enhancement was reported in 28 cases. Surgical procedures included biopsy in 26 cases and partial/total resection in the remaining 21. Histological diagnosis was of low-grade glioma in 23 patients, high-grade glioma in 22 and non-diagnostic in 2 cases. Data regarding molecular biology were available for 22 patients. Median overall survival was 35 months, in particular 16 months in high-grade glioma and 84 months in low-grade glioma. At univariate analysis, tumour grade was the only factor with a statistically significant impact on survival time (p = 0,003), whereas younger age, better performance status and total/subtotal resection showed a trend to more prolonged survival. This study also confirms safety of biopsy/surgery in adult brainstem glioma patients and shows a clear trend to a more frequent assessment of molecular biology data.ConclusionsFurther prospective multicentre efforts, and hopefully clinical trials, are necessary to improve outcome in this neglected glioma patient population.

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