LAUSR

AIM Glioblastomas are the most common malignant brain tumors. Although they are highly infiltrative tumors, they rarely metastasize extracranially. Therefore, this study aimed to identify effects of different immunohistochemical features of glioblastoma seldom observed in spinal metastases based on the metastatic spread and survival rate. MATERIAL AND METHODS A total of 214 patients who were diagnosed with and operated for brain tumor in our clinic between 2007 and 2018 and pathologically diagnosed with glioblastoma were retrospectively evaluated. Among them, 141 medical records were reviewed, and 23 of them underwent spinal magnetic rezonance imaging postoperatively due to various complaints. RESULTS All patients with glioblastoma with spinal metastases had negative isocitrate dehydrogenase 1 in the immunohistochemical examination. The incidence of spinal metastasis is 1.91%. The median KI-67 index is 30 (range, 4-90; median KI-67 index: 30+/-18.5). Isocitrate dehydrogenase mutation is wild in 55%, mutant in 33%, and not otherwise specified in 12%. Four patients with spinal metastasis has wild-type IDH with mean KI-67 index of 60, and one of them was a woman (25%) and the remaining three were men (%75), with mean age of 32 years. CONCLUSION Gliomas with high immunohistochemical proliferation indexes and wild-type isocitrate dehydrogenase with poor prognostic features based on the new classification tended to metastasize to the spine in the early disease stage; therefore, early spinal scanning and radiation therapy might extend the life expectancy. High KI-67 index and the presence of wild-type isocitrate dehydrogenase may be the predictive factors for spinal screening.