Twenty Years After Glioblastoma Multiforme Diagnosis: A Case of Long-Term Survival

Rabab’h, Omar; Al-Ramadan, Ali; Shah, Jawad; Lopez-Negrete, Hugo; Gharaibeh, Abeer

doi:10.7759/cureus.16061

Cited by 8 publications

(5 citation statements)

References 33 publications

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“…A negative correlation exists between the age at which GBM is identified and prognosis. The 10-year relative survival rate declines from 15.2% to 5.7% between 20-44 and 45-54 years of age, respectively 12, 13 .…”

Section: Discussionmentioning

confidence: 94%

Overview of prognostic factors in adult glioma; a 10-year experience at a single institution

Behrooz,

Ramandi,

Latifi-Navid

et al. 2024

Preprint

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Objective: The most prevalent central nervous system (CNS) neoplasm arising from glial cells is glioma, which diffusely invades brain tissue. Among gliomas, Glioblastoma (GBM) is a glioma of the highest grade and associated with a grim prognosis, with a median overall survival of 15 months with and 3-4 months without therapy. We examined how clinical variables and molecular profiles may have affected overall survival (OS) at Sina Hospital in Tehran over the past ten years. Methods: A retrospective study was conducted at Sina Hospital in Tehran, Iran, and examined patients older or equal 11 years with confirmed glioma diagnoses between 2012 and 2020. We evaluated the correlation between OS in GBM patients and sociodemographic as well as clinical factors, including age, gender, extent of tumor resection, tumor location, chemo/radiotherapy, and molecular profiling based on IDH1, MGMT, TERT, and EGFR status. Kaplan-Meier and multivariate Cox regression models were used to assess patient survival. Results: Following a comprehensive evaluation of medical records, 186 patients were enrolled in the study. The median OS was 20 months, with a 2-year survival rate of 62.5%. Among the 132 patients with available IDH measurements, 105 (79.5%) exhibited IDH1 wild-type tumors. Of the 132 patients with assessed MGMT methylation, 94 (71.2%) had MGMT methylated tumors. TERT promoter methylation was detected in 112 out of 132 cases (84.8%), while no methylation was observed in 20 cases (15.2%). Analyses using multivariable models revealed that age at histological grade (P < 0.0001), adjuvant radiotherapy (P < 0.014), IDH1 status (P < 0.026), and TERT promoter status (P < 0.030) were independently associated with OS. Conclusion: The findings of this study demonstrate that patients with higher tumor histological grades who had received adjuvant radiotherapy, exhibited IDH1 mutations, or presented with TERT promoter mutations, experienced improved OS. The median survival time was 20 months, with 15.6% and 46.9% of patients surviving at 12 and 24 months, respectively.

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Section: Discussionmentioning

confidence: 94%

Overview of prognostic factors in adult glioma; a 10-year experience at a single institution

Behrooz,

Ramandi,

Latifi-Navid

et al. 2024

Preprint

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“…A negative correlation exists between the age at which GB is identified and the prognosis. The 10-year relative survival rate declines from 15.2% to 5.7% between 20–44 and 45–54 years of age, respectively [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Genetic Prognostic Factors in Adult Diffuse Gliomas: A 10-Year Experience at a Single Institution

Barzegar Behrooz,

Darzi Ramandi,

Latifi-Navid

et al. 2024

Cancers

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Gliomas are primary brain lesions involving cerebral structures without well-defined boundaries and constitute the most prevalent central nervous system (CNS) neoplasms. Among gliomas, glioblastoma (GB) is a glioma of the highest grade and is associated with a grim prognosis. We examined how clinical variables and molecular profiles may have affected overall survival (OS) over the past ten years. A retrospective study was conducted at Sina Hospital in Tehran, Iran and examined patients with confirmed glioma diagnoses between 2012 and 2020. We evaluated the correlation between OS in GB patients and sociodemographic as well as clinical factors and molecular profiling based on IDH1, O-6-Methylguanine-DNA Methyltransferase (MGMT), TERTp, and epidermal growth factor receptor (EGFR) amplification (EGFR-amp) status. Kaplan–Meier and multivariate Cox regression models were used to assess patient survival. A total of 178 patients were enrolled in the study. The median OS was 20 months, with a 2-year survival rate of 61.0%. Among the 127 patients with available IDH measurements, 100 (78.7%) exhibited mutated IDH1 (IDH1-mut) tumors. Of the 127 patients with assessed MGMT promoter methylation (MGMTp-met), 89 (70.1%) had MGMT methylated tumors. Mutant TERTp (TERTp-mut) was detected in 20 out of 127 cases (15.7%), while wildtype TERTp (wildtype TERTp-wt) was observed in 107 cases (84.3%). Analyses using multivariable models revealed that age at histological grade (p < 0.0001), adjuvant radiotherapy (p < 0.018), IDH1 status (p < 0.043), and TERT-p status (p < 0.014) were independently associated with OS. Our study demonstrates that patients with higher tumor histological grades who had received adjuvant radiotherapy exhibited IDH1-mut or presented with TERTp-wt experienced improved OS. Besides, an interesting finding showed an association between methylation of MGMTp and TERTp status with tumor location.

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“…In the United States, the incidence of gliomas varies from 4.7 to 5.7 per 100,000 persons ( 2 ), representing more than 18,500 new cases and 13,000 deaths annually ( 3 ). Glioblastoma multiforme (GBM), the most common and aggressive form of glioma, has a median survival of 16 months ( 4 ), carrying a five-year post-diagnosis survival rate of 6.8% ( 5 ). While the pathogenesis differs considerably, low-grade glioma has a more favorable timespan, ranging from 5.6 to 13.3 years, depending on several prognostic factors ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Intra-operative applications of augmented reality in glioma surgery: a systematic review

Ragnhildstveit,

Li,

Zimmerman

et al. 2023

Front. Surg.

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BackgroundAugmented reality (AR) is increasingly being explored in neurosurgical practice. By visualizing patient-specific, three-dimensional (3D) models in real time, surgeons can improve their spatial understanding of complex anatomy and pathology, thereby optimizing intra-operative navigation, localization, and resection. Here, we aimed to capture applications of AR in glioma surgery, their current status and future potential.MethodsA systematic review of the literature was conducted. This adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. PubMed, Embase, and Scopus electronic databases were queried from inception to October 10, 2022. Leveraging the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) framework, study eligibility was evaluated in the qualitative synthesis. Data regarding AR workflow, surgical application, and associated outcomes were then extracted. The quality of evidence was additionally examined, using hierarchical classes of evidence in neurosurgery.ResultsThe search returned 77 articles. Forty were subject to title and abstract screening, while 25 proceeded to full text screening. Of these, 22 articles met eligibility criteria and were included in the final review. During abstraction, studies were classified as “development” or “intervention” based on primary aims. Overall, AR was qualitatively advantageous, due to enhanced visualization of gliomas and critical structures, frequently aiding in maximal safe resection. Non-rigid applications were also useful in disclosing and compensating for intra-operative brain shift. Irrespective, there was high variance in registration methods and measurements, which considerably impacted projection accuracy. Most studies were of low-level evidence, yielding heterogeneous results.ConclusionsAR has increasing potential for glioma surgery, with capacity to positively influence the onco-functional balance. However, technical and design limitations are readily apparent. The field must consider the importance of consistency and replicability, as well as the level of evidence, to effectively converge on standard approaches that maximize patient benefit.

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Twenty Years After Glioblastoma Multiforme Diagnosis: A Case of Long-Term Survival

Cited by 8 publications

References 33 publications

Overview of prognostic factors in adult glioma; a 10-year experience at a single institution

Overview of prognostic factors in adult glioma; a 10-year experience at a single institution

Genetic Prognostic Factors in Adult Diffuse Gliomas: A 10-Year Experience at a Single Institution

Intra-operative applications of augmented reality in glioma surgery: a systematic review

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