Adverse prognosis and distinct progression patterns after concurrent chemoradiotherapy for glioblastoma with synchronous subventricular zone and corpus callosum invasion

Liang, Hsiang-Kuang; Kuo, Sung‐Hsin; Wang, Chunwei; Chen, Wan‐Yu; Hsu, Chun-Yao; Lai, Shiau Ting; Tseng, Ham‐Min; You, San–Lin; Chen, Chung-Ming; Tseng, Wen‐Yih Isaac

doi:10.1016/j.radonc.2015.11.017

Cited by 33 publications

(24 citation statements)

References 29 publications

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“…Individual patient survival data derived from digitized Kaplan–Meier curves of OS, available in ten studies [11, 13–15, 18–20, 22, 23, 25] (LV+GBM n = 709; LV−GBM n = 663), and PFS, available in five studies [14, 18, 19, 22, 25] (LV+GBM n = 454; LV−GBM n = 423), were pooled together for generation of cumulative, representative OS and PFS Kaplan–Meier curves of patients included in our meta-analyses (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Influence of glioblastoma contact with the lateral ventricle on survival: a meta-analysis

et al. 2016

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The ventricular-subventricular zone (V-SVZ), which lies in the walls of the lateral ventricles (LV), is the largest neurogenic niche within the adult brain. Whether radiographic contact with the LV influences survival in glioblastoma (GBM) patients remains unclear. We assimilated and analyzed published data comparing survival in GBM patients with (LV+GBM) and without (LV−GBM) radiographic LV contact. PubMed, EMBASE, and Cochrane electronic databases were searched. Fifteen studies with survival data on LV+GBM and LV−GBM patients were identified. Their Kaplan–Meier survival curves were digitized and pooled for generation of median overall (OS) and progression free (PFS) survivals and log-rank hazard ratios (HRs). The log-rank and reported multivariate HRs after accounting for the common predictors of GBM survival were analyzed separately by meta-analyses. The calculated median survivals (months) from pooled data were 12.95 and 16.58 (OS), and 4.54 and 6.25 (PFS) for LV+GBMs and LV−GBMs, respectively, with an overall log-rank HRs of 1.335 [1.204–1.513] (OS) and 1.387 [1.225–1.602] (PFS). Meta-analysis of log-rank HRs resulted in summary HRs of 1.58 [1.35–1.85] (OS, 10 studies) and 1.41 [1.22–1.64] (PFS, 5 studies). Meta-analysis of multivariate HRs resulted in summary HRs of 1.35 [1.14–1.58] (OS, 6 studies) and 1.64 [0.88–3.05] (PFS, 3 studies). Patients with GBM contacting the LV have lower survival. This effect may be independent of the common predictors of GBM survival, suggesting a clinical influence of V-SVZ contact on GBM biology.

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Section: Resultsmentioning

confidence: 99%

Influence of glioblastoma contact with the lateral ventricle on survival: a meta-analysis

et al. 2016

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“…By nature of their anatomic proximity, VSVZ contact is likely coincident with CC contact in many cases, thus their analytic relationship with survival may demonstrate collinearity, confounding the survival outcome noted with CC contact. One recent study noted that 100% of the CC+ GBMs studied were also VSVZ+ GBMs, and that CC contact was not predictive of survival [18]. …”

Section: Discussionmentioning

confidence: 99%

“…OsiriX Lite software (version 7.0, Pixmeo, Geneva, Switzerland) was used to calculate tumor volume, assess tumor multifocality, and assess contact of the post-contrast enhancement of the GBM with the lateral walls of the lateral ventricle (VSVZ), medial edge of the hippocampus (SGZ), cortex, and corpus callosum (CC). These contact assessments are commonly performed in other studies [18, 24] and examples are depicted in Figure 1. The original study classifying GBMs into four classes based on VSVZ and cortical contact provided the rationale for evaluating cortical contact [19].…”

Section: Methodsmentioning

confidence: 99%

“…While some studies suggest a greater malignant potential of GBMs with VSVZ contact (VSVZ+ GBMs), the majority of these studies were conducted on small cohorts (<100 total patients) [12]. Further, the cumulative clinical data is limited by heterogeneous accounting of common, well-known survival confounders and other clinical variables such as extent of resection and tumor volume [12–18]. On the other hand, the clinical impact of GBM contact with SGZ is relatively unexplored.…”

Section: Introductionmentioning

confidence: 99%

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Decreased survival in glioblastomas is specific to contact with the ventricular-subventricular zone, not subgranular zone or corpus callosum

et al. 2017

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Background The clinical effect of radiographic contact of glioblastoma (GBM) with neurogenic zones (NZ)—the ventricular-subventricular (VSVZ) and subgranular (SGZ) zones—and the corpus callosum (CC) remains unclear and, in the case of the SGZ, unexplored. We investigated 1) if GBM contact with a NZ correlates with decreased survival; 2) if so, whether this effect is associated with a specific NZ; and 3) if radiographic contact or invasion by GBM of the CC, the largest identifiable white matter tract, is associated with decreased survival. Methods We retrospectively identified 207 adult patients who underwent cytoreductive surgery for GBM followed by chemotherapy and/or radiation. Age, preoperative Karnofsky performance status score (KPS), and extent of resection were recorded. Preoperative MRIs were blindly analyzed to calculate tumor volume and contact with VSVZ, SGZ, CC, and cortex. Overall (OS) and progression free (PFS) survivals were calculated and analyzed with multivariate Cox analyses. Results Among 207 patients, 111 had GBM contacting VSVZ (VSVZ+GBMs), 23 SGZ+GBMs, 52 CC+GBMs, and 164 cortex+GBMs. VSVZ+, SGZ+, and CC+ GBMs had significantly larger volume relative to non-contacting controls. In addition to age, KPS, gross total resection, chemotherapy, and radiation, multivariate Cox survival analyses revealed contact with VSVZ as an independent predictor of lower OS and the only predictor of lower PFS and early recurrence. Conclusions GBM contact with the VSVZ, but not SGZ, CC, or cortex, is associated with early recurrence and decreased survival. We hypothesize that the VSVZ niche has unique properties that contribute to GBM pathobiology in adults.

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“…Despite certain conclusive prognostic factors (e.g. extent of tumor resection, age at diagnosis and Karnofsky performance status) for glioma having been identified (2,3), prognosis remains unsatisfactory, which indicates the involvement of other factors. Therefore, a more accurate prognostic indicator for patients with glioma is required.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory biomarkers in prognostic analysis for patients with glioma and the establishment of a nomogram

et al. 2018

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Being biomarkers that reflect host nutritional and immune status, prognostic nutritional index (PNI) and neutrophil/lymphocyte ratio (NLR) have been identified to be independent prognostic factors in various malignancies. The aim of the present study was to determine the predictive value of these parameters for the prognosis of patients with glioma. Hematological and clinicopathological data were retrospectively analyzed from 128 patients with glioma who underwent brain tumor resection between January 2008 and December 2012. Receiver operating characteristic (ROC) analysis was used to determine the optimal cutoffs for PNI and NLR. Kaplan-Meier survival analysis, and univariate and multivariate analyses based on Cox proportional hazards regression model were used to determine whether NLR and PNI were associated with the prognosis of patients with glioma. R software was used to develop nomograms with all the independent prognostic factors included. Kaplan-Meier analysis followed by log-rank tests indicated that NLR ≥2.8 and PNI <45 were significantly associated with decreased overall survival time. The subsequent multivariate analysis indicated that age ≥50 years [hazard ratio (HR), 2.328; 95% confidence interval (CI), 1.386-3.908; P<0.001], high-grade glioma (HR, 3.088; 95% CI, 1.893-5.037; P<0.001), gross total resection (HR, 0.606; 95% CI, 0.380-0.965; P= 0.035) and NLR ≥2.8 (HR, 2.037; 95% CI, 1.264-3.281; P= 0.003) were independent prognostic factors. The results of the present study indicated that high NLR was an independent risk factor for overall survival rates in patients with glioma, which indicated its value in improving the current prognostic model.

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Adverse prognosis and distinct progression patterns after concurrent chemoradiotherapy for glioblastoma with synchronous subventricular zone and corpus callosum invasion

Cited by 33 publications

References 29 publications

Influence of glioblastoma contact with the lateral ventricle on survival: a meta-analysis

Influence of glioblastoma contact with the lateral ventricle on survival: a meta-analysis

Decreased survival in glioblastomas is specific to contact with the ventricular-subventricular zone, not subgranular zone or corpus callosum

Inflammatory biomarkers in prognostic analysis for patients with glioma and the establishment of a nomogram

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