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. 2021 Jul;163(7):1895-1905.
doi: 10.1007/s00701-021-04802-6. Epub 2021 Mar 20.

Survival of glioblastoma in relation to tumor location: a statistical tumor atlas of a population-based cohort

Even Hovig Fyllingen  1   2 , Lars Eirik Bø  3 , Ingerid Reinertsen  3 , Asgeir Store Jakola  4   5   6 , Lisa Millgård Sagberg  7   8 , Erik Magnus Berntsen  9   10 , Øyvind Salvesen  8 , Ole Solheim  4   7
Affiliations

Survival of glioblastoma in relation to tumor location: a statistical tumor atlas of a population-based cohort

Even Hovig Fyllingen et al. Acta Neurochir (Wien). 2021 Jul.

Abstract

Purpose: Previous studies on the effect of tumor location on overall survival in glioblastoma have found conflicting results. Based on statistical maps, we sought to explore the effect of tumor location on overall survival in a population-based cohort of patients with glioblastoma and IDH wild-type astrocytoma WHO grade II-III with radiological necrosis.

Methods: Patients were divided into three groups based on overall survival: < 6 months, 6-24 months, and > 24 months. Statistical maps exploring differences in tumor location between these three groups were calculated from pre-treatment magnetic resonance imaging scans. Based on the results, multivariable Cox regression analyses were performed to explore the possible independent effect of centrally located tumors compared to known prognostic factors by use of distance from center of the third ventricle to contrast-enhancing tumor border in centimeters as a continuous variable.

Results: A total of 215 patients were included in the statistical maps. Central tumor location (corpus callosum, basal ganglia) was associated with overall survival < 6 months. There was also a reduced overall survival in patients with tumors in the left temporal lobe pole. Tumors in the dorsomedial right temporal lobe and the white matter region involving the left anterior paracentral gyrus/dorsal supplementary motor area/medial precentral gyrus were associated with overall survival > 24 months. Increased distance from center of the third ventricle to contrast-enhancing tumor border was a positive prognostic factor for survival in elderly patients, but less so in younger patients.

Conclusions: Central tumor location was associated with worse prognosis. Distance from center of the third ventricle to contrast-enhancing tumor border may be a pragmatic prognostic factor in elderly patients.

Keywords: General population; Glioblastoma; MRI; Neurosurgery; Survival; Tumor atlas.

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Conflict of interest statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Flow chart of the inclusion process
Fig. 2
Fig. 2
Left: overview of the Montreal Neurological Institute (MNI) space. Right: distribution map of all patients (resection + biopsy, N = 215) with increasing number of cases in each voxel from light blue to dark blue
Fig. 3
Fig. 3
Log odds ratio maps for voxels with p ≤ 0.01 showing differences in overall survival (OS) based on tumor location (resection + biopsy) between (a) OS 6–24 months vs. OS < 6 months (n = 174), (b) OS > 24 months vs. OS 6–24 months (n = 163), and (c) OS > 24 months vs. OS < 6 months (n = 93). Green voxels have positive log odds ratios, which imply higher tumor odds in the first of the two groups, and thus indicate higher OS for patients with tumors in these areas. Red voxels have negative log odds ratios, which imply lower tumor odds in the first of the two groups, and thus indicate lower OS for patients with tumors in these areas
See this image and copyright information in PMC

Comment in

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