Can lateral ventricle contact predict the ontogeny and prognosis of glioblastoma?

Abstract

Lateral ventricle contact (LVC) by glioblastomas has been proposed to reveal their origin and may have prognostic value; however, results from previous studies have been controversial. This study explored the association between LVC and tumor origin and prognosis in glioblastoma patients. Magnetic resonance imaging and clinical data from 115 glioma patients were retrospectively reviewed, and Kaplan-Meier analysis and Cox proportional hazards models were used to assess the occurrence of LVC as a function of survival in 43 glioblastoma patients. The mRNA expression profiles were compared by microarray analysis in LV-contacting and non-LV-contacting glioblastomas (LVCGs and NLVCGs, respectively). The sphere-forming and invasive capabilities of LVCG- and NLVCG-derived stem cells were compared in primary glioma stem cell cultures with tumorsphere formation and Matrigel assays, respectively. LVC was more frequently detected in high-grade gliomas which, along with LVCGs, were significantly larger than low-grade gliomas and NLVCGs. LVC parameters were not independent predictors of glioblastoma patient prognosis; the expression profiles (including stemness genes expression) were similar between LVCGs and NLVCGs, and no significant differences were observed in tumorsphere-forming capacity and invasiveness between stem cells derived from the two glioblastoma types. Our results suggest that the origin of glioblastomas cannot be simply estimated by radiographic LVC, and after standard therapy the prognostic value of LVC needs to be carefully interpreted.

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

“…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).…”

“…Other confounding variables accounted in these studies included pre-operative motor deficits and intraoperative polifeprosan with carmustine wafer implantation [11, 12, 16], tumor multifocality [14], vaccine administration [15], and MGMT promoter methylation or IDH1 mutation status [22]. …”

“…However, no significant difference in the expression of several stem cell genes between GBMs with and without radiographic LV or V-SVZ contact has been uncovered to date [13, 21, 22]. Two studies explored the molecular signature of sub-classifications [9] of GBMs based on ventricular contact.…”

“…Second, most published studies did not adjust survival for known molecular prognostic indicators in GBM—MGMT promoter methylation or IDH1 mutation status. Only a few studies have reported promoter MGMT methylation or IDH1 mutation status of LV+GBMs and LV−GBMs [19, 22, 25, 47], and taking them collectively, presently no clear association of GBM molecular status with contact to the LV is discernable.…”

“…We thank Dr. Tseng for providing unpublished Kaplan–Meier survival curves of LV+GBM and LV−GBM patient data analyzed in the study Liang et al [22]. …”