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The clinical characteristics and outcomes of incidentally discovered glioblastoma

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Abstract

Objective

With an increase in the number of imaging examinations and the development of imaging technology, a small number of glioblastomas (GBMs) are identified by incidental radiological images. These incidentally discovered glioblastomas (iGBMs) are rare, and their clinical features are not well understood. Here, we investigated the clinical characteristics and outcomes of iGBM.

Methods

Data of newly diagnosed iGBM patients who were treated at our institution between August 2005 and October 2019 were reviewed. An iGBM was defined as a GBM without a focal sign, discovered on radiological images obtained for reasons unrelated to the tumor. Kaplan–Meier analysis was performed to calculate progression-free survival (PFS) and overall survival (OS).

Results

Of 315 patients with newly diagnosed GBM, four (1.3%) were classified as having iGBM. Health screening was the most common reason for tumor discovery (75.0%). The preoperative Karnofsky performance status score was 100 in three patients. Tumors were found on the right side in three cases. The mean volume of preoperative enhanced tumor lesion was 16.8 cm3. The median duration from confirmation of an enhanced lesion to surgery was 13.5 days. In all cases, either total (100%) or subtotal (95–99%) resections were achieved. The median PFS and OS were 10.5 and 20.0 months, respectively.

Conclusions

The iGBMs were often small and in the right non-eloquent area, and the patients had good performance status. We found that timely therapeutic intervention provided iGBM patients with favorable outcomes. This report suggests that early detection of GBM may lead to a better prognosis.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Daisuke Kawauchi, Makoto Ohno, Mai Honda-Kitahara, Yasuji Miyakita, Masamichi Takahashi, Shunsuke Yanagisawa, Yukie Tamura, Miyu Kikuchi, Miyu Kikuchi & Yoshitaka Narita

  2. Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo, Japan

    Koichi Ichimura

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  1. Daisuke Kawauchi
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  2. Makoto Ohno
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Contributions

Conceptualization: YN; Methodology: DK, MO, YN; Formal analysis and investigation: DK, MO, MH-K, KI; Writing—original draft preparation: DK; Writing—review and editing: MO, YN; Funding acquisition: YN; Resources: YN; Supervision: MO, YM, MT, SY, YT, MK, KI, YN.

Corresponding author

Correspondence to Yoshitaka Narita.

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Conflict of interest

All the authors have nothing to disclose except Dr. Ichimura and Dr. Narita. Dr. Ichimura reports grants from Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., and Daiichi Sankyo Co.Ltd., outside the submitted work. Dr. Narita reports grants from Japan Agency for Medical Research and Development, Chugai Pharmaceutical co., MSD, Eisai, Toshiba, SBI pharma, Glaxo, Abbive, Ono, Stella-pharma, Ohtuka, Meiji-seika, and Daiichi-Sankyo, outside the submitted work.

Ethical approval

This study was conducted retrospectively using data obtained for clinical purposes. This study was approved by the Internal Review Board of the National Cancer Center (Approval Number: 2004–066).

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Supplementary Information

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11060_2021_3931_MOESM1_ESM.tiff

Supplementary file1 Figure 1 Kaplan-Meier curves for PFS (A) and OS (B) in patients with symptomatic GBM (n = 211) and iGBM (n =4). The median PFS of symptomatic GBM and iGBM were 8.0 and 10.5 months (p=0.64), and OS were 16.0 and 20.0 months (p=0.49), respectively (TIFF 2706 kb)

11060_2021_3931_MOESM2_ESM.tiff

Supplementary file2 Figure 2 Kaplan-Meier curves for PFS (A) and OS (B) in patients with symptomatic GBM with MGMT-unmethylated (n = 129) and iGBM (n = 4). The median PFS of symptomatic GBM with MGMT-unmethylated and iGBM were 7.0 and 10.5 months (p=0.55), and OS were 14.0 and 20.0 months (p=0.29), respectively (TIFF 2706 kb)

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Kawauchi, D., Ohno, M., Honda-Kitahara, M. et al. The clinical characteristics and outcomes of incidentally discovered glioblastoma. J Neurooncol 156, 551–557 (2022). https://doi.org/10.1007/s11060-021-03931-3

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