2025 Proffered Presentations
S120: ADJUVANT CHEMORADIATION CONFERS A SURVIVAL BENEFIT IN SELLAR/SUPRASELLAR ADULT ATYPICAL TERATOID RHABDOID TUMOR
Miguel A Hernandez-Rovira, BS1; Michelle Connor, MD2; Rob Osario, MD3; Emilie Russler-Germain, MD, PhD4; Robert E Schmidt, MD, PhD4; Gabrielle W Johnson, MD, MSCI2; Julie Silverstein, MD5; Sonika Dahiya, MD4; Nyssa F Farrell, MD6; Mia C Weiss, MD7; Gregory J Zipfel, MD2; Jiayi Huang, MD8; Dimitrios Mathios, MD2; 1School of Medicine, Washington University in St. Louis, St. Louis, MO 63110; 2Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO 63110; 3Department of Neurosurgery, University of California San Francisco, San Francisco, CA 94143; 4Department of Pathology & Immunology, Washington University in St. Louis, St. Louis, MO 63110; 5Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110; 6Department of Otolaryngology, Washington University in St. Louis, St. Louis, MO 63110; 7Division of Oncology, Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110; 8Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO 63110
Introduction: Atypical teratoid rhabdoid tumors (ATRTs), aggressive WHO grade 4 tumors typically presenting in the pediatric population and associated with a very poor prognosis, currently have a median overall survival of eleven months. Despite their usual adult presentation as sellar/suprasellar masses, no studies assessing factors associated with increased survival have focused on this entity.
Methods: A comprehensive literature review of documented cases of sellar/suprasellar ATRT in adult (age ≥ 18 years) was performed and information on patient treatment and overall survival was obtained. Spearman’s r was used to assess the relationship between age and overall survival (OS) and Mann-Whitney’s test was used to assess the impact of post-surgical treatment modalities on patient outcomes.
Results: A total of 48 patients were included, 45 of which were female and 3 of which were male. Mean age at diagnosis was 46.5 ± 13.8 years. Spearman’s r showed a significant negative correlation between age at diagnosis and OS (-0.3448, CI -0.5988 to -0.02773, p = 0.0294). Exactly 35 patients had detailed information regarding post-operative treatment, those who did not undergo adjuvant chemoradiation (n = 10) had a mean OS of 2.65 months, whereas those who did (n = 25) had a mean OS of 23.8. This difference was shown to be statistically significant (p < 0.0001). No differences in OS were observed between single-agent (n = 2) and multi-agent (n = 20) chemotherapy (p = 0.5541). Likewise, no differences in OS between localized (n = 5) and craniospinal (n = 7) radiation (p = 0.6705) were observed.
Conclusions: Patient age at diagnosis and treatment with adjuvant chemoradiation are associated with greater overall survival, no particular regimen was associated with greater survival. Further studies are required to optimize treatment strategies for ATRTs.