Clinical implications of multiple glioblastomas: An analysis of prognostic factors and survival to distinguish from their single counterparts.

Purpose: Glioblastoma (GBM) has the highest fatality rate among primary malignant brain tumors. GBMs with synchronous multiple foci (multiple GBMs) is rarely diagnosed in the clinical scenario. This study aims to compare the clinical characteristics between multiple and single GBMs and to identify f...

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Publicado en:Journal of the Formosan Medical Association Vol. 119; no. 3; pp. 728 - 735
Autores principales: Shieh, Li-Tsun, Guo, How-Ran, Chang, Yu-Kang, Lu, Na-Mi, Ho, Sheng-Yow
Formato: Journal Article
Publicado: Elsevier B.V. Mar2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2020
      vid: 119
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      pub: Elsevier B.V.
      place: New York, New York
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        10.1016/j.jfma.2019.08.024
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        atl: Clinical implications of multiple glioblastomas: An analysis of prognostic factors and survival to distinguish from their single counterparts.
      aug:
        au:
          Shieh, Li-Tsun
          Guo, How-Ran
          Chang, Yu-Kang
          Lu, Na-Mi
          Ho, Sheng-Yow
        affil: Department of Radiation Oncology, Chi-Mei Medical Center, Liouying, Tainan, Taiwan
      sug:
        subj:
          Brain Neoplasms Mortality
          Glioma Mortality
          Male
          Prognosis
          Young Adult
          Brain Neoplasms Therapy
          Retrospective Design
          Aged
          Glioma Therapy
          Taiwan
          Brain Neoplasms Radiotherapy
          Aged, 80 and Over
          Glioma Radiotherapy
          Brain Pathology
          Middle Age
          Survival Analysis
          Adult
          Female
          Arthritis Impact Measurement Scales
          Scales
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Male
          Female
      ab: Purpose: Glioblastoma (GBM) has the highest fatality rate among primary malignant brain tumors. GBMs with synchronous multiple foci (multiple GBMs) is rarely diagnosed in the clinical scenario. This study aims to compare the clinical characteristics between multiple and single GBMs and to identify factors associated with the survival of GBM and evaluate their effects.Methods: We retrospectively reviewed the medical records of patients with primary GBM in a referral medical center in Taiwan who were diagnosed between 2005 and 2016. They were identified from the cancer registry database of the center and followed from the date of diagnosis to october 2018. The primary endpoint of this study was overall survival (OS), and the independent factors for survival were identified through Cox regressions.Results: A total of 48 patients were identified, of whom 44 GBM (92%) and 4 gliosarcoma (GSM) (8%). Preoperative images showed five (10%) patients had multiple brain lesions. GSM showed a high ratio of multiple lesions (50%) than patients with GBM (5%) (p = 0.05). Those with multiple lesions had significantly worse median OS of 8.2 months compared to patients with a single lesion (16 months, p = 0.03). We found that multiple GBMs was a predictor of worse survival (hazard ratio [HR] = 3.57, 95% confidence interval [95%CI]: 1.26-10.13) after adjusting for other significant predictor of radiotherapy (HR = 0.47, 95%CI: 0.23-0.96).Conclusion: Patients with multiple GBMs had worse survival compared to those with single GBM. GBM patients without post-operative radiotherapy were also a predictor of worse survival.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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