Abstract
Background
Many reports on glioblastoma multiforme discuss the prognostic impact of anatomical features such as cysts, necrotic changes, extent of edema or subependymal spread of tumor cells. In the present study, we examined different growth patterns and their possible relations to patient survival.
Methods
To analyze whether anatomical characteristics are related to prognosis, we reviewed the prospectively collected pre- and postoperative MRIs of 83 patients in the 5-ALA study, provided by the 5-ALA Glioma Study Group. Following a standardized analytic work flow, the tumor volume and site, presence of necrosis or cysts, and perifocal edema were assessed preoperatively. In the same way, postoperative MRI and the MRI at first recurrence were analyzed. In addition, survival time of the patients was documented.
Results
Median survival time of all 83 patients was 15.1 months (range 1.5 to 70.1, mean 18). The site or volume of glioblastoma, as well as the presence of intratumoral necrosis or cysts, did not exert a significant effect on survival time; 96.4 % of recurrences occurred within the former resection margin. Tumors with initial contact with the subependymal zone had multifocal or ventricular recurrences significantly more often. In patients with residual tumor on early postoperative MRI, the follow-up images displayed enlargement of the remnants in 91.9 % of these cases.
Conclusions
A merely anatomical analysis of the glioblastoma growth pattern cannot reliably provide prognostic information. The occurrence of most recurrences next to the resection margin and the high percentage of growing residual tumors underline the importance of complete resections.
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Abbreviations
- ctx+:
-
Tumor tissue is present in the cerebral cortex
- ctx-:
-
Tumor tissue is absent in the cerebral cortex
- GBM:
-
Glioblastoma multiforme
- n.a.:
-
Not applicable
- n.r.:
-
Not reported
- svz+:
-
Tumor tissue is present in the subventricular zone
- svz-:
-
Tumor tissue is absent in the subventricular zone
- T2w-HSC:
-
T2-weighted hyperintense signal change
- p.s.:
-
Present study
- Parts of this article were published as an oral presentation at the meeting of the Neurooncologic Group of the German Society of Neurosurgery (Jahrestagung der Sektion Neuroonkologie der DGNC):
-
Bonn 2009
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Nestler, U., Lutz, K., Pichlmeier, U. et al. Anatomic features of glioblastoma and their potential impact on survival. Acta Neurochir 157, 179–186 (2015). https://doi.org/10.1007/s00701-014-2271-x
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DOI: https://doi.org/10.1007/s00701-014-2271-x