Background: Unilateral adult thalamic gliomas are rarely reported. In this study, the authors aimed to analyze the clinical, radiological, and pathological features of adult primary unilateral thalamus gliomas (UTGs).
Methods: Clinical data of 33 UTGs in adults who underwent surgical treatment between 2005 and 2014 at the Beijing Tiantan Hospital were collected and retrospectively studied. Follow-up evaluation was performed.
Results: This study included 21 males and 12 females with a mean age of 43.1 years. The most common symptoms were headache (75.8%, 25/33 patients) and motor deficits (42.4%, 14/33 patients). Radiological results showed that enhancement was common (90.9%, 30/33 patients) and included cystic appearances in 9 cases (27.3%). All patients underwent maximal safe tumor resection. Gross total resection (GTR) was achieved in 19 cases, subtotal resection (≥80%) in 9 cases, and partial resection (<80%) in 5 cases. Molecular pathology results were available in 15 cases. After surgery, 25 patients received postoperative adjuvant therapy based on the remaining pathology. The median follow-up period of all 33 patients with UTGs was 17 months (1 week~49 months). Twenty-four patients experienced tumor recurrence. The 1-year and 2-year progression-free survival (PFS) rates were 49.0 and 10.2%, respectively. The 1-year and 2-year overall survival (OS) rates were 68.1 and 25.9%, respectively. Survival analyses revealed that several predictive factors were correlated with better prognosis, among which, GTR and tumor with cystic appearances were significantly associated with a longer survival.
Conclusions: Adult UTGs displayed a wide spectrum of clinical features. GTR can be achieved in adult UTGs with acceptable complications and conferred a better prognosis. Tumor with cystic appearance may indicate better prognosis. More patients and longer follow-up periods are needed to further elucidate the biological features of adult UTGs.
Keywords: Gross total resection; Prognosis; Unilateral thalamic glioma.