scholarly journals Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients

2019 ◽  
Author(s):  
Paula Whitmire ◽  
Cassandra R Rickertsen ◽  
Andrea Hawkins-Daarud ◽  
Eduardo Carrasco ◽  
Julia Lorence ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Cell ◽  
Clinical Information ◽  
Extent Of Resection ◽  
Idh1 Mutation ◽  
T Test ◽  
Primary Glioblastoma ◽  
Specific Effects ◽  
Prognostic Importance ◽  
Specific Impact

Abstract Background : Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences. Methods : Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females). Results : Among males, tumor (T1Gd) radius was a predictor of overall survival (HR=1.027, p=0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR=1.011, p<0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p=0.010 t-test), but tumor size was not correlated with female overall survival (p=0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p=0.004, F p=0.001, t-test). Additionally, extent of resection, tumor laterality, and IDH1 mutation status were also found to have sex-specific effects on overall survival. Conclusion : Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.

scholarly journals Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients

2019 ◽  
Author(s):  
Paula Whitmire ◽  
Cassandra R Rickertsen ◽  
Andrea Hawkins-Daarud ◽  
Eduardo Carrasco ◽  
Julia Lorence ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Cell ◽  
Clinical Information ◽  
Extent Of Resection ◽  
Idh1 Mutation ◽  
T Test ◽  
Primary Glioblastoma ◽  
Specific Effects ◽  
Prognostic Importance ◽  
Specific Impact

Abstract Background: Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences. Methods: Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females). Results: Among males, tumor (T1Gd) radius was a predictor of overall survival (HR=1.027, p=0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR=1.011, p<0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p=0.010 t-test), but tumor size was not correlated with female overall survival (p=0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p=0.004, F p=0.001, t-test). Additionally, extent of resection, tumor laterality, and IDH1 mutation status were also found to have sex-specific effects on overall survival. Conclusion: Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.

scholarly journals Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients

2018 ◽  
Author(s):  
Paula Whitmire ◽  
Cassandra R. Rickertsen ◽  
Andrea Hawkins-Daarud ◽  
Eduardo Carrasco ◽  
Julia Lorence ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Cell ◽  
Clinical Information ◽  
Extent Of Resection ◽  
Idh1 Mutation ◽  
T Test ◽  
Biological Factor ◽  
Mr Images ◽  
Primary Glioblastoma ◽  
Specific Impact

BackgroundSex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences.MethodsCombining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients. Pretreatment MR images of 494 glioblastoma patients (299 males and 195 females) were segmented to quantify tumor volumes. Cox proportional hazard (CPH) models and Student’s t-tests were used to assess which variables were associated with survival outcomes.ResultsAmong males, tumor (T1Gd) radius was a predictor of overall survival (HR=1.027, p=0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR=1.011, p<0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p=0.010 t-test), but tumor size was not correlated with female overall survival (p=0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p=0.004, F p=0.001, t-test). Additionally, extent of resection, tumor laterality, and IDH1 mutation status were also found to have sex-specific effects on overall survival.ConclusionDespite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes, which emphasizes the importance of considering sex as a biological factor when determining patient prognosis and treatment approach.

scholarly journals Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients

2020 ◽  
Author(s):  
Paula Whitmire ◽  
Cassandra R Rickertsen ◽  
Andrea Hawkins-Daarud ◽  
Eduardo Carrasco ◽  
Julia Lorence ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Cell ◽  
Clinical Information ◽  
T Test ◽  
Mr Images ◽  
Specific Difference ◽  
Primary Glioblastoma ◽  
Prognostic Importance ◽  
Males And Females ◽  
Specific Impact

Abstract Background : Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences. Methods : Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females). Results : Among males, tumor (T1Gd) radius was a predictor of overall survival (HR=1.027, p=0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR=1.011, p<0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p=0.010 t-test), but tumor size was not correlated with female overall survival (p=0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p=0.004, F p=0.001, t-test). Conclusion : Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.

scholarly journals Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients

2020 ◽  
Author(s):  
Paula Whitmire ◽  
Cassandra R Rickertsen ◽  
Andrea Hawkins-Daarud ◽  
Eduardo Carrasco ◽  
Julia Lorence ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Cell ◽  
Clinical Information ◽  
T Test ◽  
Mr Images ◽  
Specific Difference ◽  
Primary Glioblastoma ◽  
Prognostic Importance ◽  
Males And Females ◽  
Specific Impact

Abstract Background : Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences. Methods : Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females). Results : Among males, tumor (T1Gd) radius was a predictor of overall survival (HR=1.027, p=0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR=1.011, p<0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p=0.010 t-test), but tumor size was not correlated with female overall survival (p=0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p=0.004, F p=0.001, t-test). Conclusion : Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.

scholarly journals Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients

2019 ◽  
Author(s):  
Paula Whitmire ◽  
Cassandra R Rickertsen ◽  
Andrea Hawkins-Daarud ◽  
Eduardo Carrasco ◽  
Julia Lorence ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Cell ◽  
Clinical Information ◽  
T Test ◽  
Mr Images ◽  
Specific Difference ◽  
Primary Glioblastoma ◽  
Prognostic Importance ◽  
Males And Females ◽  
Specific Impact

Abstract Background : Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences. Methods : Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females). Results : Among males, tumor (T1Gd) radius was a predictor of overall survival (HR=1.027, p=0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR=1.011, p<0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p=0.010 t-test), but tumor size was not correlated with female overall survival (p=0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p=0.004, F p=0.001, t-test). Conclusion : Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.

scholarly journals Tumor Mesenchymal Stem-Like Cell as a Prognostic Marker in Primary Glioblastoma

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Seon-Jin Yoon ◽  
Jin-Kyoung Shim ◽  
Jong Hee Chang ◽  
Ju Hyung Moon ◽  
Tae-Hoon Roh ◽  
...  
Keyword(s):  
Overall Survival ◽  
Molecular Markers ◽  
Brain Tumors ◽  
Regression Model ◽  
Clinical Characteristics ◽  
Median Overall Survival ◽  
Cox Regression ◽  
Extent Of Resection ◽  
Tumor Removal ◽  
Primary Glioblastoma

The isolation from brain tumors of tumor mesenchymal stem-like cells (tMSLCs) suggests that these cells play a role in creating a microenvironment for tumor initiation and progression. The clinical characteristics of patients with primary glioblastoma (pGBM) positive for tMSLCs have not been determined. This study analyzed samples from 82 patients with pGBM who had undergone tumor removal, pathological diagnosis, and isolation of tMSLC from April 2009 to October 2014. Survival, extent of resection, molecular markers, and tMSLC culture results were statistically evaluated. Median overall survival was 18.6 months, 15.0 months in tMSLC-positive patients and 29.5 months in tMSLC-negative patients (P=0.014). Multivariate cox regression model showed isolation of tMSLC (OR = 2.5, 95% CI = 1.1~5.6,P=0.021) showed poor outcome while larger extent of resection (OR = 0.5, 95% CI = 0.2~0.8,P=0.011) has association with better outcome. The presence of tMSLCs isolated from the specimen of pGBM is associated with the survival of patient.

scholarly journals Survival in patients with glioblastoma at a first progression does not correlate with isocitrate dehydrogenase (IDH)1 gene mutation status

2020 ◽  
Vol 51 (1) ◽  
pp. 45-53
Author(s):  
Yusuke Tabei ◽  
Keiichi Kobayashi ◽  
Kuniaki Saito ◽  
Saki Shimizu ◽  
Kaori Suzuki ◽  
...  
Keyword(s):  
Overall Survival ◽  
Dna Methyltransferase ◽  
Median Overall Survival ◽  
Idh1 Mutation ◽  
Newly Diagnosed ◽  
Wild Type ◽  
Secondary Glioblastoma ◽  
Primary Glioblastoma ◽  
Methylguanine Dna Methyltransferase ◽  
Mutant Idh1

Abstract Backgrounds Mutations in the isocitrate dehydrogenase (IDH)1 gene are favourable prognostic factors in newly diagnosed diffuse gliomas, whereas it remains controversial in the recurrent glioblastoma setting. Methods A total of 171 patients with newly diagnosed glioblastoma, either ‘primary’ glioblastoma or ‘secondary’ glioblastoma, treated at Kyorin University Hospital or Japanese Red Cross Medical Center from 2000 to 2015 were included. Patients with confirmed IDH1 status and O6-methylguanine-DNA methyltransferase promoter methylation status were retrospectively analysed for overall survival from the initial diagnosis (n = 147) and after the first progression (n = 122). Results IDH1 mutation but not IDH2 was noted in 19 of 147 patients with glioblastoma (12.9%). In patients with ‘primary’ glioblastoma (n = 136), median overall survival after the first progression was 13.5 and 10.5 months for mutant IDH1 and wild-type IDH1 glioblastoma, respectively (P = 0.747). Multivariate analysis revealed O6-methylguanine-DNA methyltransferase promoter methylation, and Karnofsky Performance status 60 or higher, were independent prognostic factors for better overall survival after the first progression. When ‘primary’ glioblastoma and ‘secondary’ glioblastoma were combined, median overall survival from the first progression was not significantly different between the mutant IDH1 group (10.1 months) and wild-type IDH1 group (10.5 months) (P = 0.559), whereas median overall survival from the initial diagnosis was significantly different (47.5 months vs.18.3 months, respectively; P = 0.035). Conclusions These results suggest that IDH1 mutation may not be a prognostic factor for survival at the first progression of patients with ‘primary’ glioblastoma and pretreated ‘secondary’ glioblastoma, and further warrant investigation in prospective studies.

The role of postradiation temozolomide in patients with newly diagnosed MGMT methylated glioblastoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13530-e13530
Author(s):  
Yuqing Sun ◽  
Carlos G Romo ◽  
Pavan Shah ◽  
Stuart A. Grossman
Keyword(s):  
Overall Survival ◽  
Extent Of Resection ◽  
Idh1 Mutation ◽  
Johns Hopkins Hospital ◽  
Karnofsky Performance Score ◽  
Newly Diagnosed ◽  
Normal Functional ◽  
Newly Diagnosed Glioblastoma ◽  
Post Radiation ◽  
A Prospective Study

e13530 Background: Standard therapy for patients with newly diagnosed glioblastoma (GBM) includes concurrent temozolomide (TMZ) and radiation (RT) followed by six monthly cycles of adjuvant TMZ. Although TMZ improves survival for MGMT methylated patients, it is unclear if this benefit is from the TMZ given with the radiation, the adjuvant TMZ, or if both are required. This retrospective study was designed to identify MGMT methylated patients who started treatment with near-normal functional status, completed concurrent RT+TMZ, but did not receive adjuvant TMZ to estimate if their survival was significantly less than expected. Methods: We reviewed charts from 190 adults diagnosed with GBM at Johns Hopkins Hospital from 2013 to 2015 recording their Karnofsky Performance Score (KPS), extent of resection, MGMT-methylation and IDH1 mutation status, and treatment records. We selected patients with MGMT-methylated GBM who received concurrent RT+TMZ without adjuvant TMZ for this study. Patients with a KPS < 70 or severe post-radiation complications were excluded. Results: Six patients met the selection criteria. They had a median age of 65 years, average KPS of 80, 2/6 had a gross total resection, and all were IDH1 wildtype. Their overall survival ranged from 17 to > 46 months. Conclusions: The overall survival of these patients who received no adjuvant TMZ is very similar to the median of 23 months reported in the literature for MGMT methylated patients who received adjuvant TMZ. This preliminary data suggests that a prospective study in MGMT methylated patients comparing concurrent RT+TMZ followed by either standard adjuvant TMZ or observation could be considered without placing patients in the experimental arm at excessive risk.[Table: see text]

scholarly journals Overall Survival Prediction in Renal Cell Carcinoma Patients Using Computed Tomography Radiomic and Clinical Information

2021 ◽  
Author(s):  
Zahra Khodabakhshi ◽  
Mehdi Amini ◽  
Shayan Mostafaei ◽  
Atlas Haddadi Avval ◽  
Mostafa Nazari ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Clinical Features ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Clinical Information ◽  
Tumor Grade ◽  
Imaging Biomarkers ◽  
Area Density

AbstractThe aim of this work is to investigate the applicability of radiomic features alone and in combination with clinical information for the prediction of renal cell carcinoma (RCC) patients’ overall survival after partial or radical nephrectomy. Clinical studies of 210 RCC patients from The Cancer Imaging Archive (TCIA) who underwent either partial or radical nephrectomy were included in this study. Regions of interest (ROIs) were manually defined on CT images. A total of 225 radiomic features were extracted and analyzed along with the 59 clinical features. An elastic net penalized Cox regression was used for feature selection. Accelerated failure time (AFT) with the shared frailty model was used to determine the effects of the selected features on the overall survival time. Eleven radiomic and twelve clinical features were selected based on their non-zero coefficients. Tumor grade, tumor malignancy, and pathology t-stage were the most significant predictors of overall survival (OS) among the clinical features (p < 0.002, < 0.02, and < 0.018, respectively). The most significant predictors of OS among the selected radiomic features were flatness, area density, and median (p < 0.02, < 0.02, and < 0.05, respectively). Along with important clinical features, such as tumor heterogeneity and tumor grade, imaging biomarkers such as tumor flatness, area density, and median are significantly correlated with OS of RCC patients.

scholarly journals Neurotoxicity of subarachnoid Gd-based contrast agent accumulation: a potential complication of intraoperative MRI?

2021 ◽  
Vol 50 (1) ◽  
pp. E12
Author(s):  
Monika Lauer ◽  
Arne Lauer ◽  
Se-Jong You ◽  
Sara Kluge ◽  
Elke Hattingen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Contrast Agent ◽  
Malignant Glioma ◽  
Adjuvant Treatment ◽  
Subarachnoid Space ◽  
Case Series ◽  
Extent Of Resection ◽  
Intraoperative Mri ◽  
Control Group ◽  
Icu Stay

OBJECTIVEIntraoperative MRI with Gd-based contrast agent (GBCA) improves the extent of resection of contrast-enhancing brain tumors. Signal changes of CSF due to perioperative GBCA leakage in the subarachnoid space have been reported. However, although GBCA potentially exhibits neurotoxic effects, so far no associated complications have been described. In this case series, the authors report a single-center cohort of patients with subarachnoid GBCA extravasation after intraoperative MRI and discuss potential neurotoxic complications and potential ways of avoiding them.METHODSAll patients with CSF signal increase on unenhanced T1-weighted and FLAIR images on postoperative MRI, who had previously undergone tumor resection with use of intraoperative MRI, were retrospectively included and compared with a control cohort. The control group was matched in age, tumor characteristics, and extent of resection; comparisons were made regarding postoperative seizures and ICU stay. A subgroup with initially diagnosed malignant glioma was additionally analyzed for potential delay of initiation of adjuvant treatment and overall survival.RESULTSSeven patients with postoperative GBCA accumulation in the subarachnoid space were identified; 5 presented with focal seizures and altered mental status postoperatively. Poor patient condition led to extended ICU stay and prolonged delay of the initiation of adjuvant treatment in patients with newly diagnosed malignant glioma. Overall survival was reduced compared to the matched control group.CONCLUSIONSThe results suggest that there might be a risk of neurotoxic complications if GBCA that is intravenously applied during neurosurgery leaks into the subarachnoid space. Patients with highly vascularized tumors with intraoperative bleeding seem to be especially at risk for GBCA accumulation and neurotoxic complications. Therefore, awareness of the potential risk of complicating GBCA leakage is mandatory in the application of intraoperative GBCA.

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