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Cystic glioblastoma multiforme: survival
outcomes in 22 cases
Maldaun MV, Suki D, Lang FF, Prabhu S, Shi W, Fuller GN, Wildrick DM, Sawaya
R
Department of Neurosurgery, The University of Texas M. D.
Anderson Cancer Center, Houston, Texas 77030, USA.
Object. The goal of this study was to determine whether the presence of a
large tumor cyst was associated with improved outcome in patients undergoing
surgery for newly diagnosed glioblastomas multiforme (GBMs) by comparing these
patients with a matched cohort of patients with noncystic GBMs in clinical
features, tumor imaging characteristics, survival, and time to tumor recurrence
after surgery.
Methods. A retrospective analysis was conducted in 22 patients by
using imaging information and chart reviews of operative reports of GBMs with
large cysts (> or = 50% of tumor volume) at The University of Texas M. D.
Anderson Cancer Center between 1993 and 2002.
Clinical and neurosurgical outcomes and recurrence rates were studied.
A statistical comparison was made with a matching cohort of 22 patients with
noncystic GBMs.
No significant differences in clinical variables were found between the cohort
with cystic GBMs and the matched cohort with noncystic GBMs.
To avoid bias in preoperative assessment of tumor volume, the tumor burden was
compared in patients whose tumors had cysts (excluding the cystic mass) and in
patients whose tumors did not contain cysts.
There was no statistically significant difference between the two groups (p =
0.8).
In patients with cystic GBMs the median survival time after surgery was 18.2
months (95% confidence interval [CI] 11.9-24.5 months) and at 2 years 43% of the
patients were still alive.
In comparison, in patients with noncystic GBMs, the median survival time was
14.3 months (95% CI 12.1-16.4 months) and only 16% of patients were alive at 2
years.
The median time to tumor recurrence was 7.6 months (95% CI 0.01-18 months) in
patients harboring cystic GBMs and 4.2 months (95% CI 1.8-6.6 months) in the
matched cohort (log-rank test, p = 0.04).
In the cystic GBM group, no recurrence was observed in 53% of patients at 6
months, 45% at 1 year, and 38% at 2 years after surgery, whereas the
corresponding numbers for the noncystic group were 36, 14, and 9%,
respectively.
Conclusions. The results indicate that patients harboring a GBM that
contains a large cyst survive longer and have a longer time to recurrence than
those who lack such a cyst. This is the first such observation in the
literature.
PMID: 14743913 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14743913
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