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Cancers 2019, 11(1), 122; https://doi.org/10.3390/cancers11010122

Location-Dependent Patient Outcome and Recurrence Patterns in IDH1-Wildtype Glioblastoma

1
Division of Experimental Neurosurgery, Department of Neurosurgery, University Hospital Heidelberg, INF 400, D-69120 Heidelberg, Germany
2
Department of Medical Oncology, National Center for Tumor Diseases, INF 460, D-69120 Heidelberg, Germany
3
Department of Neuroradiology, Clinic of Neurology, University Hospital Heidelberg, INF 400, D-69120 Heidelberg, Germany
4
Department of Neuropathology, Institute of Pathology, University of Heidelberg, German Cancer Consortium, CCU Neuropathology, German Cancer Research Center, INF 224, D-69120 Heidelberg, Germany
5
Department of Neuropathology, Charité-Universitätsmedizin, Charitéplatz 1, D-10117 Berlin, Germany
6
Department of Radiation Oncology, Heidelberg University Hospital, Molecular and Translational Radiation Oncology, National Center for Tumor Diseases, German Cancer Research Center, D-69120 Heidelberg, Germany
*
Author to whom correspondence should be addressed.
Received: 29 December 2018 / Revised: 14 January 2019 / Accepted: 15 January 2019 / Published: 21 January 2019
(This article belongs to the Special Issue Glioblastoma: State of the Art and Future Perspectives)
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Abstract

Recent 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
Keywords: Glioblastoma; isocitrate dehydrogenase 1 (IDH1)-wildtype; subventricular zone; survival; multifocal growth; distant recurrence Glioblastoma; isocitrate dehydrogenase 1 (IDH1)-wildtype; subventricular zone; survival; multifocal growth; distant recurrence
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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.

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