Relationship of glioblastoma multiforme to the lateral ventricles predicts survival following tumor resection

27 October 2008

Chaichana KL, McGirt MJ, Frazier J, Attenello F, Guerrero-Cazares H, Quinones-Hinojosa A.

Department of Neurosurgery, The Johns Hopkins Hospital, Johns Hopkins School of Medicine, Johns Hopkins University, CRB II, 1550 Orleans Street, Room 247, Baltimore, MD, 21231, USA.

OBJECTIVE: There has been an increased focus on the region adjacent to the lateral ventricles (LV) as a potential source of malignant tumors and/or more aggressive disease. We set out to determine if glioblastoma multiforme (GBM) bordering the LV was associated with decreased survival as compared to non-LV GBM. METHODS: We reviewed the clinical records of 69 consecutive patients undergoing craniotomy for GBM at a single academic institution. Twenty-six patients were identified with contrast-enhancing lesions (CEL) bordering the LV (LV CEL). These 26 patients were matched with 26 patients with CEL not bordering the LV (non-LV CEL). These cohorts were matched for factors consistently shown to be associated with survival, which were age, tumor size, Karnofsky performance score, extent of resection, Gliadel implantation, and Temodar chemotherapy. Overall survival was compared between the cohorts via Log-rank analysis. RESULTS: Despite similarities in pre-operative clinical status, tumor size, peri-operative outcome, and treatment regimens, the median survival for patients with LV CEL was significantly decreased as compared to patients with non-LV CEL (8 months vs. 11 months), P = 0.02. Additionally, survival analysis in patients stratified by primary and secondary resection also demonstrated a strong trend towards decreased survival after resection of LV CEL. After primary and secondary resection, patients with LV CEL versus non-LV CEL had a median survival of 11 months vs. 14 months (P = 0.10) and 7 months vs. 10 months (P = 0.11), respectively. CONCLUSION: While the causal factors underlying this observation are not provided with this observational study, GBM bordering the LV may carry a prognostic significance.

PMID: 18458819 [PubMed - indexed for MEDLINE]

Commento Personale: Interessante studio che mette in risalto come i tumori adiacienti ai ventricoli tendano ad aggravare significativamente la malattia impattando negativamente sulla sopravvivenza rispetto a chi ha recidive lontante dai ventricoli. Anche la resezione chirurgica non permette, secondo questo studio, di ottenere un vantaggio clinico su chi (al contrario) presenta lesioni lontano dai ventricoli.

Source J Neurooncol. 2008 Sep;89(2):219-24. Epub 2008 May 6