Glioblastoma with prolonged survival despite poor prognosticators

Emmanuel Costa, Tevi Morel Lawson, Julie Lelotte, Edward Fomekong, Geraldo Vaz, Nicolas Whenham, Laurette Renard, Christian Raftopoulos Published in the journal : February 2018 Category : Neurochirurgie

Summary :

Glioblastoma (GBM) is the most aggressive primary tumor of the central nervous system (CNS), and our study sought to identify the characteristics of patients with prolonged overall survival (OS). To this end, we reviewed the records of 127 patients who underwent surgery in our center for GBM between January 2002 and November 2011. We then identified those patients with prolonged survival (>3years). The characteristics of all these patients and their tumors were analyzed, and the anatomic pathological diagnosis was reviewed by a second anatomical pathologist. Of these 127 patients, 101 (79.6%) underwent excisional surgery, with 12 of these surviving longer than 36 months. The GBM diagnosis was confirmed in 11 (11%) patients (F/M: 4.5; mean age: 50 years (31-68); mean Karnofsky preoperative: 82%). The average survival of these 11 patients was 74 months (36-150); seven patients (63.6%) underwent complete resection, three (27.3%) almost complete resection, and the last one (9.1%) partial resection. Only two (18.8%) patients exhibited an IDH1 mutation. Seven (63.6%) patients benefited from a complete Stupp protocol. Eight of these patients had poor prognostic factors regarding prolonged survival (age, low Karnofsky score, or unmutated IDH). In conclusion, for any patient who develops a GBM, there is some hope that survival may be prolonged, even in the presence of poor prognosticators.

Key words

glioblastoma, prolonged survival, poor prognosis