Primary gliosarcoma: epidemiology, clinical presentation, management, and survival

J Neurosurg Sci. 2020 Aug;64(4):341-346. doi: 10.23736/S0390-5616.17.04077-2. Epub 2017 Nov 20.


Background: Gliosarcomas are malignant tumors of the central nervous system. As a variant of glioblastomas (GBM), they are treated in a similar fashion. However, there is growing evidence to suggest that they may be a separate entity.

Methods: Due to the rarity of primary gliosarcomas (PGS), here we publish data from a single center spanning over 14 years, comprising possibly one of the biggest case series in the literature to our knowledge.

Results: The mean age at presentation was 59 years with male preponderance (1.75:1). The most common presenting symptoms were balance and mobility issues (61%), followed by headaches (50%) and visual problems (39%). Tumours were most likely to involve the frontal and parietal lobes (27% and 21% respectively). Patients under 50 had a significant survival advantage (50% versus 32%). All patients had surgery, 79% had adjuvant radiotherapy, with a further 21% also receiving chemotherapy. Median survival from surgery of patients diagnosed with PGS was 6.6 months. Median and one-year survival were significantly better for patients who received radiotherapy (14 months; 46% one year survival) and improved further with combined radio- and chemotherapy (30 months; 77%, one year survival).

Conclusions: For patients of good functional status, adjuvant chemo-radiotherapy is warranted and should be offered as it confers a much-improved overall survival.

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms* / diagnosis
  • Brain Neoplasms* / epidemiology
  • Brain Neoplasms* / therapy
  • Female
  • Gliosarcoma* / diagnosis
  • Gliosarcoma* / epidemiology
  • Gliosarcoma* / therapy
  • Humans
  • Male
  • Middle Aged
  • United Kingdom / epidemiology