Prognostic differences and implications on treatment strategies between butterfly glioblastoma and glioblastoma with unilateral corpus callosum infiltration

Abstract

Approximately 25% of glioblastomas show at diagnosis a corpus callosum infiltration, which is associated with poor prognosis. The extent of corpus callosum involvement, however, ranges from partial unilateral to complete bilateral infiltration. The role of surgery in glioblastoma with corpus callosum involvement is controversial. In this study, we aimed to examine prognostic differences between glioblastoma with unilateral and glioblastoma with bilateral corpus callosum infiltration, and to evaluate possible treatment strategy implications. Patients with newly diagnosed glioblastoma from 2010 to 2019 were included. Corpus callosum infiltration was assessed in contrast-enhanced T1-weighted preoperative magnetic resonance imaging. Extent of resection, adjuvant treatments and overall survival were evaluated. Corpus callosum involvement was found in 96 (26.4%) out of 363 patients with newly diagnosed glioblastoma. Bilateral corpus callosum infiltration was found in 27 out of 96 patients (28%), and 69 patients had unilateral corpus callosum infiltration. Glioblastoma with corpus callosum affection had significantly lower median overall survival compared to glioblastoma without corpus callosum involvement (9 vs. 11 months, p = 0.02). A subgroup analysis of glioblastoma with unilateral corpus callosum infiltration revealed a significant difference in median overall survival dependent on extent of resection (6.5 without gross total resection vs. 11 months with gross total resection, Log-rank test p = 0.02). Our data confirms a shorter overall survival in glioblastoma subpopulation with corpus callosum involvement, especially for glioblastoma with bilateral corpus callosum infiltration. However, patients with partial corpus callosum infiltration undergoing gross total resection exhibited a significant survival benefit compared to their counterparts without gross total resection. Whenever reasonably achievable gross total resection should be considered as an integral part of the treatment strategy in glioblastoma with partial corpus callosum infiltration.

Extra-neural metastases in pediatric diffuse midline gliomas, H3 K27-altered: presentation of two cases and literature review

“…Interestingly, Wang et al ( 2018 ) showed that patients with H3K27M-mutant gliomas in unusual anatomical locations (cerebellum, corpus callosum, lateral ventricle, frontal, and temporal lobe) had a better prognosis compared with those with corresponding tumors in the brainstem. Recently, Hazaymeh et al ( 2022 ) showed that patients affected by glioblastoma multiforme (GBM) undergoing gross total resection exhibited a significant survival benefit compared to their counterparts without gross total resection. Our cases 1 and 2 developed osseous metastases 5 months and 6 months, respectively, since the initial diagnosis.…”

Unveiling the Antitumor Mechanism of 7α-Acetoxy-6β-Hydroxyroyleanone from<em> Plectranthus hadiensis</em> in Glioblastoma

“…Characterized by rapid growth and high invasiveness, this devastating disease has a dismal prognosis, with a median survival of approximately 15-18 months post-diagnosis even with treatment [2]. This is primarily attributed to the infiltrative behavior and localization of the tumor, as well as, to the extent of surgery and treatment resistance [3][4][5]. The established treatment protocol for GB patients involves surgical resection followed by cycles of chemoradiotherapy and adjuvant chemotherapy (temozolomide-TMZ) [6,7].…”