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. 2013 Jan;15(1):91-6.
doi: 10.1093/neuonc/nos268. Epub 2012 Oct 24.

Relationship of glioblastoma multiforme to the subventricular zone is associated with survival

Nazia F Jafri  1 , Jennifer L Clarke, Vivian Weinberg, Igor J Barani, Soonmee Cha
Affiliations

Relationship of glioblastoma multiforme to the subventricular zone is associated with survival

Nazia F Jafri et al. Neuro Oncol. 2013 Jan.

Abstract

The subventricular zone (SVZ) lines the lateral ventricles and represents the origin of neural and some cancer stem cells. Tumors contacting the SVZ may be more invasive with higher potential to recruit migratory progenitor cells. Our specific aim was to determine whether SVZ involvement in glioblastoma multiforme (GBM) is associated with a higher recurrence rate and shorter overall survival. MR imaging and clinical data from 91 patients with GBM treated at our institution were retrospectively reviewed. Tumors were classified as type I if the contrast-enhancing lesion contacted both the SVZ and cortex on pre-operative MRI, type II if only the SVZ was involved, type III if only cortex was involved, and type IV if the lesion did not contact either the SVZ or cortex. Progression-free survival (PFS) and overall survival were estimated based on Kaplan-Meier calculations. When comparing type I tumors with types II-IV, only 39% of patients with type I tumors were free of recurrence and alive at 6 months, significantly fewer than for all other types combined (67%; P = .01). PFS at 6 months was also less, at only 47% among patients with SVZ-positive tumors, compared with 69% in the SVZ-negative group (P = .002). Patients with SVZ involvement also demonstrated a more rapid time to progression, compared with those not involving the SVZ (P = .003). Patients with GBM involving the SVZ have decreased overall survival and PFS, which may have prognostic and therapeutic implications.

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Figures

Fig. 1.
Fig. 1.
Classification of GBM into types I-IV, based on MR imaging. Type I tumors contact both the SVZ and the cortex, type II tumors involve only SVZ, type III tumors involve only cortex, and type IV do not contact either SVZ or cortex. Used with permission.1
Fig. 2.
Fig. 2.
Recurrence pattern in a 46-year-old woman with type I GBM after surgical resection and chemoradiation. Image on the left demonstrating pre-operative tumor appearance with the contrast-enhancing lesion contacting both the SVZ and the cortex. Image to the right depicting a common recurrence pattern in type I tumors, with both local recurrence and remote SVZ recurrence as delineated by the arrow adjacent to the frontal horns.
Fig. 3.
Fig. 3.
Recurrence pattern in a 57-year-old man with type IV GBM. Both images demonstrate the typical pattern seen in type IV tumors with recurrence at the site of surgical resection.
Fig. 4.
Fig. 4.
PFS curve for all patients with GBM (types I-IV).
Fig. 5.
Fig. 5.
PFS curve comparing patients with SVZ-positive (types I and II) and SVZ-negative (types III and IV) disease.
Fig. 6.
Fig. 6.
Kaplan-Meier curve demonstrating survival difference between SVZ-positive and SVZ-negative tumors.
See this image and copyright information in PMC

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