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Delay in diagnosing patients with right-sided glioblastoma induced by hemispheric-specific clinical presentation

  • Clinical Study
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Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose

Cognitive functions are differentially represented in brain hemispheres. Aphasia is an “easy to recognize” symptom of diseases affecting the left side. In contrast, lesions in the right hemisphere cause subtle neuropsychological deficits such as neglect and anosognosia. We evaluated whether right-sided malignant brain tumors are on average larger at the time of first diagnosis as compared to left-sided tumors, and extrapolated the delay in diagnosing right-sided tumors compared to the left side.

Methods

All first-ever diagnosed glioblastoma (GBM) patients between 2005 and 2012 were identified using our hospital-based prospective research registry. Baseline data, information on initial clinical presentation and imaging findings (including tumor volume) were collected. Extrapolation of time since tumor initiation was based on an established gompertzian growth model.

Results

We included 173 patients. Mean age of the study population was 58 ± 13 years. Tumors located in the right hemisphere (n = 96) were larger as compared to tumors located in the left hemisphere (n = 77) (median 36.4 mL [interquartile range 13.0–56.0; minimum 0.2, maximum 140.0] vs. 17.2 mL [7.7–45.1 mL; 0.4, 105.2]; p = 0.011). Right-sided tumors grew longer than left-sided tumors (378 ± 95 days vs. 341 ± 74 days; p = 0.006). Initial neuropsychological symptoms differed depending on the affected hemisphere.

Conclusion

Right-hemispheric symptoms appear to be less clinically conspicuous resulting in a delayed diagnosis of GBM, which might be improved by raising awareness for the corresponding neuropsychological deficits. Whether our findings have prognostic implications needs to be evaluated in future studies.

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Acknowledgements

MM would like to thank the Luxembourg National Research Fond (FNR) for the support (FNR PEARL P16/BM/11192868 Grant).

Funding

The author(s) received no specific funding for this work.

Author information

Authors and Affiliations

  1. Department of Neurology, Goethe University, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany

    Claudia Baumann, Jan Hendrik Schaefer & Christian Foerch

  2. Institute of Neuroradiology, Goethe University, Frankfurt am Main, Germany

    Claudia Baumann & Marlies Wagner

  3. Dr. Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany

    Julia Tichy & Joachim P. Steinbach

  4. German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt, Germany

    Julia Tichy & Joachim P. Steinbach

  5. German Cancer Research Center (DKFZ), Heidelberg, Germany

    Julia Tichy & Joachim P. Steinbach

  6. University Cancer Center (UCT), Frankfurt, Germany

    Julia Tichy & Joachim P. Steinbach

  7. Institute of Neurology (Edinger Institute), Goethe University, Frankfurt am Main, Germany

    Michel Mittelbronn

  8. Luxembourg Centre of Neuropathology (LCNP), Luxembourg, Luxembourg

    Michel Mittelbronn

  9. Laboratoire National de Santé (LNS), Dudelange, Luxembourg

    Michel Mittelbronn

  10. Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg

    Michel Mittelbronn

  11. NORLUX Neuro-Oncology Laboratory, Department of Oncology, Luxembourg Institute of Health (L.I.H.), Luxembourg, Luxembourg

    Michel Mittelbronn

Authors
  1. Claudia Baumann
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  2. Julia Tichy
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  3. Jan Hendrik Schaefer
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  4. Joachim P. Steinbach
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  5. Michel Mittelbronn
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  6. Marlies Wagner
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  7. Christian Foerch
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Corresponding author

Correspondence to Claudia Baumann.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committee (SNO-06-2016).

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Baumann, C., Tichy, J., Schaefer, J.H. et al. Delay in diagnosing patients with right-sided glioblastoma induced by hemispheric-specific clinical presentation. J Neurooncol 146, 63–69 (2020). https://doi.org/10.1007/s11060-019-03335-4

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  • DOI: https://doi.org/10.1007/s11060-019-03335-4

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