Assessment of Prognostic Value of Cystic Features in Glioblastoma Relative to Sex and Treatment With Standard-of-Care.
Assessment of Prognostic Value of Cystic Features in Glioblastoma Relative to Sex and Treatment With Standard-of-Care.
复制标题
DOI：
10.3389/fonc.2020.580750
复制
发表时间：
2020
影响因子：
4.7
通讯作者：
Hu LS
中科院分区：
文献类型：
--
作者：
Curtin L;Whitmire P;Rickertsen CR;Mazza GL;Canoll P;Johnston SK;Mrugala MM;Swanson KR;Hu LS
胶质母细胞瘤(GBM)是最具侵袭性的原发脑肿瘤，可含有囊性成分，可通过磁共振成像(MRI)进行识别。先前的研究表明，囊性病变发生在7-23%的球基细胞瘤中，关于其预后的影响，报告的结果好坏参半。利用我们对493名初诊GBM患者的回顾队列，我们对囊性GBM和存活率之间的这种潜在联系进行了探索性分析。使用预处理核磁共振成像，我们手动确定了88名表现为囊性成分的GBM患者和405名没有囊性成分的患者。囊性GBM患者的总体生存时间显著延长，且发病时明显年轻。在接受当前标准治疗(SOC)的患者中(N=184，40个囊性)，我们没有观察到囊性GBM的生存益处。出乎意料的是，我们没有观察到这个SOC囊性队列与标准建立前诊断的囊性GBM患者(有SOC的N=40，非SOC的N=19)之间的显著生存益处；这种显著的SOC益处在非囊性GBM患者中明显观察到(有SOC的N=144，没有SOC的N=111)。当按性别分层时，囊性GBM的生存益处仅保留在男性患者(N=303，47例囊性)。我们报告了MRI上影像异常的绝对大小和相对大小的差异以及基于性别的囊性病变的预后意义。我们讨论了这些差异的假设，包括囊肿的存在可能表明肿瘤的侵袭性较弱。
Glioblastoma (GBM) is the most aggressive primary brain tumor and can have cystic components, identifiable through magnetic resonance imaging (MRI). Previous studies suggest that cysts occur in 7–23% of GBMs and report mixed results regarding their prognostic impact. Using our retrospective cohort of 493 patients with first-diagnosis GBM, we carried out an exploratory analysis on this potential link between cystic GBM and survival. Using pretreatment MRIs, we manually identified 88 patients with GBM that had a significant cystic component at presentation and 405 patients that did not. Patients with cystic GBM had significantly longer overall survival and were significantly younger at presentation. Within patients who received the current standard of care (SOC) (N = 184, 40 cystic), we did not observe a survival benefit of cystic GBM. Unexpectedly, we did not observe a significant survival benefit between this SOC cystic cohort and patients with cystic GBM diagnosed before the standard was established (N = 40 with SOC, N = 19 without SOC); this significant SOC benefit was clearly observed in patients with noncystic GBM (N = 144 with SOC, N = 111 without SOC). When stratified by sex, the survival benefit of cystic GBM was only preserved in male patients (N = 303, 47 cystic). We report differences in the absolute and relative sizes of imaging abnormalities on MRI and the prognostic implication of cysts based on sex. We discuss hypotheses for these differences, including the possibility that the presence of a cyst could indicate a less aggressive tumor.
登录
查看更多内容
影响因子：
158.5
作者：
Stupp, R;Mason, WP;Ryan, G
通讯作者：
Ryan, G
影响因子：
5.6
作者：
Camalier, Corinne E.;Yi, Ming;Yu, Li-Rong;Hood, Brian L.;Conrads, Kelly A.;Lee, Young Jae;Lin, Yiming;Garneys, Laura M.;Bouloux, Gary F.;Young, Matthew R.;Veenstra, Timothy D.;Stephens, Robert M.;Colburn, Nancy H.;Conrads, Thomas P.;Beck, George R., Jr.
通讯作者：
Beck, George R., Jr.
影响因子：
4.1
作者：
KIKUCHI, K;NEUWELT, EA
通讯作者：
NEUWELT, EA
影响因子：
17.1
作者：
Itakura H;Achrol AS;Mitchell LA;Loya JJ;Liu T;Westbroek EM;Feroze AH;Rodriguez S;Echegaray S;Azad TD;Yeom KW;Napel S;Rubin DL;Chang SD;Harsh GR 4th;Gevaert O
通讯作者：
Gevaert O
影响因子：
15.9
作者：
Ostrom, Quinn T.;Gittleman, Haley;Barnholtz-Sloan, Jill S.
通讯作者：
Barnholtz-Sloan, Jill S.