Patient age, histologic features, and length of survival in patients with glioblastoma multiforme

Abstract

Histologic sections from 71 patients with glioblastoma multiforme were reviewed to identify histologic prognostic factors and to explain the significantly shorter survival in older patients. Slides were studied for 14 histologic variables from a group of 35 patients aged less 45 years and from 36 patients aged 65 years or more. The relation of these histologic factors to the length of survival and age group was then investigated. The results document the marked histologic and cytologic heterogeneity of the glioblastoma and reaffirm the importance of necrosis as a prognostic factor. The results further suggest that patients whose glioblastomas contained microcysts, pseudopalisading, cells with astrocytic differentiation, and large areas of better differentiated glioma, did better than those patients whose lesions were homogeneously composed of small cells or whose lesion had a small median nuclear size. The study reaffirmed the strong (P less than 0.0001) negative relationship between advancing age and duration of postoperative survival. The presence of necrosis, a smaller standard deviation of nuclear size, the extent of vascular proliferation, the absence of well differentiated neoplastic fibrillary astrocytes, and neoplasms composed homogeneously of small cells were related to patient age and offered a possible explanation for at least part of the observed age effect. However, the strong relation between age and survival remained significant when adjusted for other variables, and the effect of age must rest largely on factors other than those detected in this morphologic study.

Autoantibodies against GLEA2 and PHF3 in glioblastoma: Tumor‐associated autoantibodies correlated with prolonged survival

“…Likewise, little is known about prognostic factors except for clinical and morphologic features including patient age, Karnofsky status, completeness of resection, tumor location, histology and apoptotic index. 2,3 Several molecular markers were proposed including LOH of Chromosome 10 and overexpression of EGFR, both of which correlate with poor prognosis. [4][5][6] However, as of yet, no molecular or immunologic markers for survival have been introduced into clinical practice.…”

Genetic abnormalities detected in ependymomas by comparative genomic hybridisation

“…However, gross surgical resection and the use of radiotherapy have been consistently associated with enhanced event-free and overall survival (Nazar et al, 1990;Sutton et al, 1990;Healey et al, 1991;Vanuytsel et al, 1992;Ferrante et al, 1994;Pollack et al, 1995;Bouffet et al, 1998;Robertson et al, 1998;Horn et al, 1999;Grill et al, 2001). Histological features of anaplasia, such as mitoses, microvascular proliferation and necrosis, serve as indicators of biological behaviour in other gliomas, including diffuse astrocytic tumours and oligodendrogliomas (Cohadon et al, 1985;Burger and Green, 1987;Ellison, 1998). However, the biological significance of these morphological features in ependymoma remains unclear; clinicopathological studies have provided conflicting evidence on the prognostic value of dividing ependymomas into classic (WHO grade 2) and anaplastic (grade 3) variants (Ross and Rubinstein, 1989;Sutton et al, 1990;Schiffer et al, 1991;Gerszten et al, 1996;Bouffet et al, 1998;Figarella-Branger et al, 2000).…”

Temozolomide enhances herpes simplex virus thymidine kinase/ganciclovir therapy of malignant glioma

“…25 CI < 1, CI = 1, and CI > 1 indicate synergism, additive effect, and antagonism, respectively. D m and m values for single drugs and their combinations were used for CI calculation using the equation 2 , where D x is the dose ( concentration ) for x% inhibition.zDRI ( dose -reduction index ) is measured by comparing the doses required to reach a given degree of inhibition when the drug was used alone and in combination with another drug.…”

“…1 Gliomas do not metastasize systemically, but are exceptionally migratory and invade the surrounding brain tissue very early in their natural course. 2,3 These tumors are graded according to a few defined histologic features, such as presence of mitosis, polymorphic nuclei, and abundant neoplastic vasculature. 4 High -grade gliomas (WHO grades III and IV ) are aggressive neoplasms with an uniformly fatal course despite modern multimodal treatment strategies including surgical resection, irradiation, and chemotherapy.…”