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Vol. 32. Issue 3.
Pages 114-123 (May - June 2021)
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Vol. 32. Issue 3.
Pages 114-123 (May - June 2021)
Clinical Research
DOI: 10.1016/j.neucie.2020.04.003
Histological, molecular, clinical and outcomes characteristics of Multiple Lesion Glioblastoma. A retrospective monocentric study and review of literature
Características histológicas, moleculares, clínicas y de resultados de lesiones múltiples del glioblastoma. Un estudio monocèc)ntrico retrospectivo y revisión de literatura
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Daniele Armocidaa,
Corresponding author
danielearmocida@yahoo.it

Corresponding author.
, Alessandro Pescea, Federico Di Giammarcoa, Alessandro Fratia, Maurizio Salvatib, Antonio Santoroa
a Human Neurosciences Department Neurosurgery Division “Sapienza” University, Italy
b IRCCS “Neuromed” Pozzilli (IS), Italy
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Table 1. Patient's demographics.
Abstract
Background

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.

Methods

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).

Results

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.

Conclusions

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.

Keywords:
Multifocal glioblastoma
Multicentric glioblastoma
Glioblastoma
GBM
Lateral ventricle
Survival
Tumor
Abbreviations:
SVZ
V-SVZ
LV-SVZ
DTI
DWI
EGFR
EOR
FLAIR
fMRI
GBM
GTR
HGG
IDH
IoN
IoNT
LGG
KPS
MPRAGE
NTR
STR
OS
PFS
QoL
NSC
BTPC
Resumen
Antecedentes

El glioblastoma multiforme multifocal (M-GBM) representa un grupo de pacientes con GBM en el que existen múltiples focos de mejora tumoral. El pronóstico es peor que el de los pacientes con GBM de lesión única, pero en realidad es un dato controvertido. Se desconoce si la multifocalidad tiene una base genèc)tica y molecular. Nuestro objetivo específico es identificar las características moleculares de M-GBM mediante la realización de un análisis multidimensional integral.

Mèc)todos

Los resultados quirúrgicos, radiológicos y clínicos de los pacientes que se sometieron a cirugía para GBM en nuestra institución durante 2 años han sido revisados retrospectivamente. Comparamos la supervivencia general (SG), la supervivencia libre de progresión y el grado de resección (EOR) entre los tumores M-GBM (tipo I) y S-GBM (lesión única que mejora el contraste, tipo II).

Resultados

Un total de 177 pacientes fueron incluidos en la cohorte final, 12 pacientes tenían M-GBM y 165 pacientes tenían S-GBM. Aunque los pacientes con M-GBM tenían mayores volúmenes tumorales y ubicación en la línea media, el EOR no fue diferente entre ambos tipos de lesiones. Se detectó un mayor porcentaje de tumores con sobreexpresión de EGFR en M-GBM. PFS y OS fue significativamente más corto en M-GBM.

Conclusiones

Teniendo en cuenta que no hay diferencias en EOR, los pacientes con M-GBM mostraron PFS y OS más cortos en comparación con S-GBM. Se sugieren evidencias sobre el origen de M-GBM como una lesión multifocal porque se sugiere su perfil molecular.

Palabras clave:
Multifocal glioblastoma
Multicentric glioblastoma
Glioblastoma
Ventrículos lateral
Supervivencia
Tumor

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