Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jun 18, 2022; 12(6): 131-141
Published online Jun 18, 2022. doi: 10.5500/wjt.v12.i6.131
Risk factors of extraneural spreading in astrocytomas and oligodendrogliomas in donors with gliomas: A systematic review
Serena Ammendola, Valeria Barresi, Elena Bariani, Ilaria Girolami, Antonia D’Errico, Matteo Brunelli, Massimo Cardillo, Letizia Lombardini, Amedeo Carraro, Ugo Boggi, Owen Cain, Desley Neil, Albino Eccher
Serena Ammendola, Valeria Barresi, Elena Bariani, Matteo Brunelli, Section of Pathology, Department of Diagnostics and Public Health, University of Verona, Verona 37134, Italy
Ilaria Girolami, Division of Pathology, Central Hospital, Bolzano 39100, Italy
Antonia D’Errico, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna 40138, Italy
Massimo Cardillo, Letizia Lombardini, National Transplant Center, Istituto Superiore di Sanità, Rome 00161, Italy
Amedeo Carraro, General Surgery and Liver Transplant Unit, Verona University Hospital, Verona 37126, Italy
Ugo Boggi, Division of General and Transplant Surgery, Pisa University Hospital, Pisa 56126, Italy
Owen Cain, Desley Neil, Department of Cellular Pathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, United Kingdom
Albino Eccher, Department of Pathology and Diagnostics, Verona University Hospital, Verona 37126, Italy
Author contributions: Ammendola S, Eccher A, Bariani E, Girolami I, Barresi V, Brunelli M, Boggi U, Cardillo M, and Carraro A performed the review and editing of manuscript; Ammendola S, Eccher A, Bariani E, Girolami I, and Barresi V performed the conceptualization; Ammendola S, Eccher A, Bariani E, and Girolami I performed data curation and investigation; Bariani E, Girolami I, Barresi V, Brunelli M, Boggi U, Cardillo M, Carraro A, D’Errico A, and Lombardini L performed the visualization; Ammendola S and Eccher A performed formal analysis, methodology, and preparation of the original draft; Neil D and Cain O performed the review and language editing of the manuscript; and all authors had access to the data, played a role in writing, and agreed to the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2020 Checklist, and the manuscript was prepared and revised according to the PRISMA 2020 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Serena Ammendola, MD, Doctor, Section of Pathology, Department of Diagnostics and Public Health, University of Verona, P.le L.A. Scuro 10, Verona 37134, Italy.
Received: January 7, 2022
Peer-review started: January 7, 2022
First decision: February 21, 2022
Revised: February 25, 2022
Accepted: May 22, 2022
Article in press: May 22, 2022
Published online: June 18, 2022
Research background

Under extended criteria, patients with a history of primary brain tumor can be eligible for organ donation. Tumor histotype and tumor grade are considered the main risk factors of tumor transmission, and previous surgeries, chemo-/radiotherapy, and ventriculo-peritoneal shunt placement concur to increase the transmission risk.

Research motivation

Most of the literature on the extraneural metastatic spread of diffuse gliomas is based on case reports and case series, and there is a lack of systematic appraisal of patterns of metastatic spread- and on factors concurring to increase the risk of extraneural spreading.

Research objectives

We aimed to collect and analyze the existing literature on extraneural spreading of oligodendroglial and astrocytic tumors in order to identify clinical or pathological factors that could help clinicians to assess the risk of tumor transmission from donors with a history of these gliomas and guide decision making in organ transplantation.

Research methods

We performed a systematic review of the literature in accordance with the PRISMA guidelines. A literature search without language restrictions was performed in the electronic databases MEDLINE-PubMed and EMBASE, searching for articles, case reports, and case series reporting data on extra-central nervous system metastases of oligodendrogliomas and astrocytomas.

Research results

Elapsed time from the initial diagnosis to metastatic spread ranged from 0 to 325 mo and from 0 to 276 mo for oligodendrogliomas and astrocytic tumors, respectively. The most common metastatic sites were bone and lymph nodes for both tumors, while the most common visceral sites were the lungs and the liver in patients with oligodendrogliomas and lungs, liver, and kidneys in patients with astrocytomas. Among patients with astrocytomas, 7 did not undergo surgery, chemo-/radiotherapy or ventriculo-peritoneal shunt placement before the onset of metastases.

Research conclusions

A long interval between the tumor diagnosis and the donor’s death does not exclude the possibility of extraneural spreading of these tumors. Bone and lymph nodes are the most common metastatic sites; the lungs and the liver are instead the preferential visceral sites of metastatic spread. Follow-up imaging of the skeleton and cervical lymph nodes could be useful to identify metastatic disease in donors with a history of these gliomas.

Research perspectives

The diagnostic advances made recently in tumor classification and targeted follow-up protocols could improve the knowledge on the factors involved in extraneural spreading of gliomas, with repercussions on the tumor transmission risk assessment of potential donors.