%0 Journal Article
%A Jungk, Christine
%A Warta, Rolf
%A Mock, Andreas
%A Friauf, Sara
%A Hug, Bettina
%A Capper, David
%A Abdollahi, Amir
%A Debus, Jürgen
%A Bendszus, Martin
%A von Deimling, Andreas
%A Unterberg, Andreas
%A Herold-Mende, Christel
%T Location-Dependent Patient Outcome and Recurrence Patterns in IDH1-Wildtype Glioblastoma.
%J Cancers
%V 11
%N 1
%@ 2072-6694
%C Basel
%I MDPI
%M DKFZ-2019-00564
%P 122
%D 2019
%X Recent studies suggest that glioblastomas (GBMs) contacting the subventricular zone (SVZ) as the main adult neurogenic niche confer a dismal prognosis but disregard the unique molecular and prognostic phenotype associated with isocitrate dehydrogenase 1 (IDH1) mutations. We therefore examined location-dependent prognostic factors, growth, and recurrence patterns in a consecutive cohort of 285 IDH1-wildtype GBMs. Based on pre-operative contrast-enhanced MRI, patients were allotted to four location-dependent groups with (SVZ+; groups I, II) and without (SVZ-; groups III, IV) SVZ involvement or with (cortex+; groups I, III) and without (cortex-; groups II, IV) cortical involvement and compared for demographic, treatment, imaging, and survival data at first diagnosis and recurrence. SVZ involvement was associated with lower Karnofsky performance score (p < 0.001), lower frequency of complete resections at first diagnosis (p < 0.0001), and lower non-surgical treatment intensity at recurrence (p < 0.001). Multivariate survival analysis employing a Cox proportional hazards model identified SVZ involvement as an independent prognosticator of inferior overall survival (p < 0.001) and survival after relapse (p = 0.041). In contrast, multifocal growth at first diagnosis (p = 0.031) and recurrence (p < 0.001), as well as distant recurrences (p < 0.0001), was more frequent in cortex+ GBMs. These findings offer the prospect for location-tailored prognostication and treatment based on factors assessable on pre-operative MRI.
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:30669568
%2 pmc:PMC6356480
%R 10.3390/cancers11010122
%U https://inrepo02.dkfz.de/record/142936