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. 2021 Apr 7;28(2):1437-1446.
doi: 10.3390/curroncol28020136.

On the Prognosis of Multifocal Glioblastoma: An Evaluation Incorporating Volumetric MRI

Johannes Kasper  1 , Nicole Hilbert  1 , Tim Wende  1 , Michael Karl Fehrenbach  1 , Florian Wilhelmy  1 , Katja Jähne  1 , Clara Frydrychowicz  2 , Gordian Hamerla  3 , Jürgen Meixensberger  1 , Felix Arlt  1
Affiliations

On the Prognosis of Multifocal Glioblastoma: An Evaluation Incorporating Volumetric MRI

Johannes Kasper et al. Curr Oncol. .

Abstract

Primary glioblastoma (GBM), IDH-wildtype, especially with multifocal appearance/growth (mGBM), is associated with very poor prognosis. Several clinical parameters have been identified to provide prognostic value in both unifocal GBM (uGBM) and mGBM, but information about the influence of radiological parameters on survival for mGBM cohorts is scarce. This study evaluated the prognostic value of several volumetric parameters derived from magnetic resonance imaging (MRI). Data from the Department of Neurosurgery, Leipzig University Hospital, were retrospectively analyzed. Patients treated between 2014 and 2019, aged older than 18 years and with adequate peri-operative MRI were included. Volumetric assessment was performed manually. One hundred and eighty-three patients were included. Survival of patients with mGBM was significantly shorter (p < 0.0001). Univariate analysis revealed extent of resection, adjuvant therapy regimen, residual tumor volume, tumor necrosis volume and ratio of tumor necrosis to initial volume as statistically significant for overall survival. In multivariate Cox regression, however, only EOR (for uGBM and the entire cohort) and adjuvant therapy were independently significant for survival. Decreased ratio of tumor necrosis to initial tumor volume and extent of resection were associated with prolonged survival in mGBM but failed to achieve statistical significance in multivariate analysis.

Keywords: glioblastoma; multifocal glioblastoma; volumetric assessment.

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Conflict of interest statement

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Figures

Figure 1
Figure 1
Compared survival of multifocal with unifocal glioblastoma by Kaplan–Meier analysis.
Figure 2
Figure 2
Cox regression of categorized volumetric parameters for all three study cohorts. (A): entire cohort, residual tumor volume; (B): uGBM, residual tumor volume; (C): mGBM, ratio of tumor necrosis volume to initial tumor volume; (D): entire cohort, extent of resection; (E): uGBM, extent of resection; (F): mGBM, extent of resection. mGBM: multifocal glioblastoma; uGBM: unifocal glioblastoma.
Figure 3
Figure 3
Kaplan–Meier analysis of categorized volumetric parameters for all three study cohorts. (A): entire cohort, residual tumor volume; (B): uGBM, residual tumor volume; (C): mGBM, ratio of tumor necrosis volume to initial tumor volume; (D): entire cohort, extent of resection; (E): uGBM, extent of resection; (F): mGBM, extent of resection. mGBM: multifocal glioblastoma; uGBM: unifocal glioblastoma.
See this image and copyright information in PMC

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