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Location-dependent patient outcome and recurrence patterns in IDH1-wildtype glioblastoma

Recent studies suggest that glioblastomas (GBMs) contacting the subventricular zone (SVZ) as the main adult neurogenic niche confer a dismal prognosis but disregard the unique molecular and prognostic phenotype associated with isocitrate dehydrogenase 1 (IDH1) mutations. We therefore examined locati...

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Main Authors: Jungk, Christine (Author) , Warta, Rolf (Author) , Mock, Andreas (Author) , Friauf, Sara (Author) , Capper, David (Author) , Abdollahi, Amir (Author) , Debus, Jürgen (Author) , Bendszus, Martin (Author) , Deimling, Andreas von (Author) , Unterberg, Andreas (Author) , Herold-Mende, Christel (Author)
Format: Article (Journal)
Language:English
Published: 21 January 2019
In: Cancers
Year: 2019, Volume: 11, Issue: 1
ISSN:2072-6694
DOI:10.3390/cancers11010122
Online Access:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.3390/cancers11010122
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2072-6694/11/1/122
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Author Notes:Christine Jungk, Rolf Warta, Andreas Mock, Sara Friauf, Bettina Hug, David Capper, Amir Abdollahi, Jürgen Debus, Martin Bendszus, Andreas von Deimling, Andreas Unterberg and Christel Herold-Mende
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Summary:Recent studies suggest that glioblastomas (GBMs) contacting the subventricular zone (SVZ) as the main adult neurogenic niche confer a dismal prognosis but disregard the unique molecular and prognostic phenotype associated with isocitrate dehydrogenase 1 (IDH1) mutations. We therefore examined location-dependent prognostic factors, growth, and recurrence patterns in a consecutive cohort of 285 IDH1-wildtype GBMs. Based on pre-operative contrast-enhanced MRI, patients were allotted to four location-dependent groups with (SVZ+; groups I, II) and without (SVZ&minus;; groups III, IV) SVZ involvement or with (cortex+; groups I, III) and without (cortex&minus;; groups II, IV) cortical involvement and compared for demographic, treatment, imaging, and survival data at first diagnosis and recurrence. SVZ involvement was associated with lower Karnofsky performance score (p < 0.001), lower frequency of complete resections at first diagnosis (p < 0.0001), and lower non-surgical treatment intensity at recurrence (p < 0.001). Multivariate survival analysis employing a Cox proportional hazards model identified SVZ involvement as an independent prognosticator of inferior overall survival (p < 0.001) and survival after relapse (p = 0.041). In contrast, multifocal growth at first diagnosis (p = 0.031) and recurrence (p < 0.001), as well as distant recurrences (p < 0.0001), was more frequent in cortex+ GBMs. These findings offer the prospect for location-tailored prognostication and treatment based on factors assessable on pre-operative MRI.
Item Description:Gesehen am 06.02.2019
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers11010122

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