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Glioblastomas at the white matter of temporo-parietal junction cause a poor postoperative independence level

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Right cerebral hemispheric glioblastomas (GBMs) often decrease the Karnofsky performance status (KPS) score postoperatively, despite the patient having sufficient patient function while performing daily living. This study aimed to evaluate the factors that could cause poor KPS scores during the postoperative chronic phase in patients with right cerebral hemispheric GBMs.


Data of 47 patients with newly diagnosed right cerebral hemispheric GBMs were analyzed. All patients were assessed preoperatively and 3 months postoperatively to determine KPS and brain function. To determine tumor location related to the postoperative KPS scores, we used voxel-based lesion symptom mapping (VLSM). The patients were divided into two groups (involvement and non-involvement groups) based on whether their lesion involved a significant region identified by VLSM. We then compared functional factors and prognosis between the groups using the chi-squared and log-rank tests, respectively.


The KPS score significantly decreased after surgery compared to that preoperatively measured (p = 0.023). VLSM revealed that tumors in the white matter of temporo-parietal junction (WM-TPJ) caused a significant decline in the KPS score at three months postoperatively. The patients in the involvement group had a higher probability of impaired attention, visuospatial cognition, emotion recognition, and visual field than did those in the non-involvement group. In addition, tumor in the WM-TPJ were associated with shorter progression-free survival and overall survival (p = 0.039 and 0.023, respectively).


GBMs involving the right WM-TPJ are more likely to result in poor postoperative KPS scores and prognoses. Impairments of several kinds of brain functions caused by tumor invasion to the WM-TPJ may be associated with lower KPS scores.

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This work was supported by JSPS KAKENHI Grant Number 21H03301 and 21K19705.

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Authors and Affiliations



Conception and design: MN and RN Acquisition of data: RN. Analysis and interpretation of data: RN. Drafting article: MN, RN. Critically revising the article: All authors Reviewed the final version of the manuscript and approved it for submission. Study supervision: MN.

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Correspondence to Mitsutoshi Nakada.

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The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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This study was conducted in accordance with the guidelines of the Internal Review Board of Kanazawa University and was approved by the Medical Ethics Committee of Kanazawa University (approval numbers 1797 and 3284).

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Written informed consent to participate in this study was obtained from all patients.

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Nakajima, R., Kinoshita, M., Okita, H. et al. Glioblastomas at the white matter of temporo-parietal junction cause a poor postoperative independence level. J Neurooncol 165, 191–199 (2023).

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