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J Neurol Surg A Cent Eur Neurosurg 2021; 82(02): 112-117
DOI: 10.1055/s-0040-1713172
Original Article

Aggressive Treatment in Glioblastoma: What Determines the Survival of Patients?

Lei Yu 
1   Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
,
Guozhong Zhang
1   Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
,
Songtao Qi
1   Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Abstract

Background and Study Aims The exact reason of long-term survival in glioblastoma (GBM) patients has remained uncertain. Molecular parameters in addition to histology to define malignant gliomas are hoped to facilitate clinical, experimental, and epidemiological studies.

Material and Methods A population of GBM patients with similar clinical characteristics (especially similar resectability) was reviewed to compare the molecular variables between poor (overall survival [OS] < 18 months, control cohort) and long-term survivors (overall survival > 36 months, OS-36 cohort).

Results Long-term GBM survivors were younger. In the OS-36 cohort, the positive rate of isocitrate dehydrogenase (IDH) mutation was very low (7.69%, 3/39) and there was no statistical difference in OS between IDH mutant and wild-type patients. The results of 1p/19q codeletions are similar. Besides, there were no significant difference in MGMT promoter methylation, telomerase reverse transcriptase (TERT) promoter mutation, and TP53 mutations between OS-36 cohort and control cohort.

Conclusions No distinct markers consistently have been identified in long-term survivors of GBM patients, and great importance should be attached to further understand the biological characteristics of the invasive glioma cells because of the nature of diffuse tumor permeation.

Keywords

glioblastoma - long-term survival - IDH1 - 1p/19q codeletions - MGMT - TERT


Publication History

Received: 07 August 2019

Accepted: 23 March 2020

Article published online:
06 November 2020

© 2020. Thieme. All rights reserved.

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  • References

  • 1 Hilf N, Kuttruff-Coqui S, Frenzel K. et al. Actively personalized vaccination trial for newly diagnosed glioblastoma. Nature 2019; 565 (7738): 240-245
    CrossrefPubMedGoogle Scholar
  • 2 Puchalski RB, Shah N, Miller J. et al. An anatomic transcriptional atlas of human glioblastoma. Science 2018; 360 (6389): 660-663
    CrossrefPubMedGoogle Scholar
  • 3 Gately L, McLachlan SA, Philip J, Ruben J, Dowling A. Long-term survivors of glioblastoma: a closer look. J Neurooncol 2018; 136 (01) 155-162
    CrossrefPubMedGoogle Scholar
  • 4 Louis DN, Perry A, Reifenberger G. et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016; 131 (06) 803-820
    CrossrefPubMedGoogle Scholar
  • 5 Hartmann C, Hentschel B, Simon M. et al; German Glioma Network. Long-term survival in primary glioblastoma with versus without isocitrate dehydrogenase mutations. Clin Cancer Res 2013; 19 (18) 5146-5157
    CrossrefPubMedGoogle Scholar
  • 6 Cantero D, Rodríguez de Lope Á, Moreno de la Presa R. et al. Molecular study of long-term survivors of glioblastoma by gene-targeted next-generation sequencing. J Neuropathol Exp Neurol 2018; 77 (08) 710-716
    CrossrefPubMedGoogle Scholar
  • 7 Li XZ, Li YB, Cao Y. et al. Prognostic implications of resection extent for patients with glioblastoma multiforme: a meta-analysis. J Neurosurg Sci 2017; 61 (06) 631-639
    PubMedGoogle Scholar
  • 8 Eyüpoglu IY, Hore N, Merkel A, Buslei R, Buchfelder M, Savaskan N. Supra-complete surgery via dual intraoperative visualization approach (DiVA) prolongs patient survival in glioblastoma. Oncotarget 2016; 7 (18) 25755-25768
    CrossrefPubMedGoogle Scholar
  • 9 Eyüpoglu IY, Buchfelder M, Savaskan NE. Surgical resection of malignant gliomas-role in optimizing patient outcome. Nat Rev Neurol 2013; 9 (03) 141-151
    CrossrefPubMedGoogle Scholar
  • 10 Gessler F, Forster MT, Duetzmann S. et al. Combination of intraoperative magnetic resonance imaging and intraoperative fluorescence to enhance the resection of contrast enhancing gliomas. Neurosurgery 2015; 77 (01) 16-22 , discussion 22
    CrossrefPubMedGoogle Scholar
  • 11 Senft C, Forster MT, Bink A. et al. Optimizing the extent of resection in eloquently located gliomas by combining intraoperative MRI guidance with intraoperative neurophysiological monitoring. J Neurooncol 2012; 109 (01) 81-90
    CrossrefPubMedGoogle Scholar
  • 12 Eyüpoglu IY, Hore N, Savaskan NE. et al. Improving the extent of malignant glioma resection by dual intraoperative visualization approach. PLoS One 2012; 7 (09) e44885
    CrossrefPubMedGoogle Scholar
  • 13 Senft C, Bink A, Franz K, Vatter H, Gasser T, Seifert V. Intraoperative MRI guidance and extent of resection in glioma surgery: a randomised, controlled trial. Lancet Oncol 2011; 12 (11) 997-1003
    CrossrefPubMedGoogle Scholar
  • 14 Yu SQ, Wang JS, Chen SY. et al. Diagnostic significance of intraoperative ultrasound contrast in evaluating the resection degree of brain glioma by transmission electron microscopic examination. Chin Med J (Engl) 2015; 128 (02) 186-190
    CrossrefPubMedGoogle Scholar
  • 15 Bush NA, Chang SM, Berger MS. Current and future strategies for treatment of glioma. Neurosurg Rev 2017; 40 (01) 1-14
    CrossrefPubMedGoogle Scholar
  • 16 Emmanuel C, Lawson T, Lelotte J. et al. Long-term survival after glioblastoma resection: hope despite poor prognosis factors. J Neurosurg Sci 2019; 63 (03) 251-257
    PubMedGoogle Scholar
  • 17 Salford LG, Brun A, Nirfalk S. Ten-year survival among patients with supratentorial astrocytomas grade III and IV. J Neurosurg 1988; 69 (04) 506-509
    CrossrefPubMedGoogle Scholar
  • 18 Giese A, Bjerkvig R, Berens ME, Westphal M. Cost of migration: invasion of malignant gliomas and implications for treatment. J Clin Oncol 2003; 21 (08) 1624-1636
    CrossrefPubMedGoogle Scholar
  • 19 Hegi ME, Diserens AC, Gorlia T. et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005; 352 (10) 997-1003
    CrossrefPubMedGoogle Scholar
  • 20 Stupp R, Mason WP, van den Bent MJ. et al; European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005; 352 (10) 987-996
    CrossrefPubMedGoogle Scholar
  • 21 Weller M, Stupp R, Hegi ME. et al. Personalized care in neuro-oncology coming of age: why we need MGMT and 1p/19q testing for malignant glioma patients in clinical practice. Neuro-oncol 2012; 14 (Suppl. 04) iv100-iv108
    PubMedGoogle Scholar
  • 22 Nguyen HN, Lie A, Li T. et al. Human TERT promoter mutation enables survival advantage from MGMT promoter methylation in IDH1 wild-type primary glioblastoma treated by standard chemoradiotherapy. Neuro-oncol 2017; 19 (03) 394-404
    PubMedGoogle Scholar
  • 23 Wang Y, Jiang T. Understanding high grade glioma: molecular mechanism, therapy and comprehensive management. Cancer Lett 2013; 331 (02) 139-146
    CrossrefPubMedGoogle Scholar
  • 24 Sarmiento JM, Mukherjee D, Black KL. et al. Do long-term survivor primary glioblastoma patients harbor IDH1 mutations?. J Neurol Surg A Cent Eur Neurosurg 2016; 77 (03) 195-200
    Article in Thieme ConnectPubMedGoogle Scholar