Location-Dependent Patient Outcome and Recurrence Patterns in IDH1-Wildtype Glioblastoma
AbstractRecent 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−; groups III, IV) SVZ involvement or with (cortex+; groups I, III) and without (cortex−; 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. View Full-Text
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Jungk, C.; Warta, R.; Mock, A.; Friauf, S.; Hug, B.; Capper, D.; Abdollahi, A.; Debus, J.; Bendszus, M.; von Deimling, A.; Unterberg, A.; Herold-Mende, C. Location-Dependent Patient Outcome and Recurrence Patterns in IDH1-Wildtype Glioblastoma. Cancers 2019, 11, 122.
Jungk C, Warta R, Mock A, Friauf S, Hug B, Capper D, Abdollahi A, Debus J, Bendszus M, von Deimling A, Unterberg A, Herold-Mende C. Location-Dependent Patient Outcome and Recurrence Patterns in IDH1-Wildtype Glioblastoma. Cancers. 2019; 11(1):122.Chicago/Turabian Style
Jungk, Christine; Warta, Rolf; Mock, Andreas; Friauf, Sara; Hug, Bettina; Capper, David; Abdollahi, Amir; Debus, Jürgen; Bendszus, Martin; von Deimling, Andreas; Unterberg, Andreas; Herold-Mende, Christel. 2019. "Location-Dependent Patient Outcome and Recurrence Patterns in IDH1-Wildtype Glioblastoma." Cancers 11, no. 1: 122.
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