Human Neurosciences Department Neurosurgery Division "Sapienza" University, Italy.
Human Neurosciences Department Neurosurgery Division "Sapienza" University, Italy.
Neurocirugia (Astur : Engl Ed). 2021 May-Jun;32(3):114-123. doi: 10.1016/j.neucir.2020.04.003. Epub 2020 Jun 18.
Multiple lesion glioblastoma (M-GBM) represent a group of GBM patients in which there exist multiple foci of tumor enhancement. The prognosis is poorer than that of single-lesion GBM patients, but this actually is a controversial data. Is unknown whether multifocality has a genetic and molecular basis. Our specific aim is to identify the molecular characteristics of M-GBM by performing a comprehensive multidimensional analysis.
The surgical, radiological and clinical outcomes of patients that underwent surgery for GBM at our institution for 2 years have been retrospectively reviewed. We compared the overall survival (OS), progression free survival and extent of resection (EOR) between M-GBM tumors (type I) and S-GBM (single contrast-enhancing lesion, type II).
A total of 177 patients were included in the final cohort, 12 patients had M-GBM and 165 patients had S-GBM. Although patients with M-GBM had higher tumor volumes and midline location, the EOR was not different between both type of lesions. Higher percentage of tumors with EGFR overexpression was detected in M-GBM. PFS and OS was significantly shorter in M-GBM.
Considering no differences in EOR, patients with M-GBM showed shorter PFS and OS in comparison with S-GBM. Evidences about the M-GBM origin as a multifocal lesion because its molecular profile are suggested.
多发性病变胶质母细胞瘤(M-GBM)代表了一组存在多个肿瘤增强焦点的 GBM 患者。其预后比单病灶 GBM 患者差,但这实际上是一个有争议的数据。目前尚不清楚多病灶是否具有遗传和分子基础。我们的具体目的是通过进行全面的多维分析来确定 M-GBM 的分子特征。
我们回顾性分析了在我们机构接受 GBM 手术的患者的手术、影像学和临床结果。我们比较了 M-GBM 肿瘤(I 型)和 S-GBM(单一对比增强病变,II 型)之间的总生存期(OS)、无进展生存期和切除程度(EOR)。
共有 177 例患者被纳入最终队列,其中 12 例为 M-GBM,165 例为 S-GBM。尽管 M-GBM 患者的肿瘤体积和中线位置较高,但两种病变之间的 EOR 没有差异。M-GBM 中检测到更高比例的 EGFR 过表达肿瘤。M-GBM 的 PFS 和 OS 明显缩短。
考虑到 EOR 没有差异,与 S-GBM 相比,M-GBM 患者的 PFS 和 OS 更短。提示 M-GBM 作为多灶性病变的起源存在分子谱证据。