Artikel
Growth dynamic of untreated glioblastoma multiforme
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Autoren
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Daniel Rueß
- Klinik und Poliklinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Universitätsklinikum Köln
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Tobias Blau
- Institut für Neuropathologie, Universitätsklinikum Köln
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Christoph Wipplinger
- Klinik und Poliklinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Universitätsklinikum Köln
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Lukas Koller
- Klinik und Poliklinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Universitätsklinikum Köln
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Harald Treuer
- Klinik und Poliklinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Universitätsklinikum Köln
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Maximilian I. Ruge
- Klinik und Poliklinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Universitätsklinikum Köln
| Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: To conduct stereotactic biopsy with highest precision MR imaging should – especially in cases of fast growing tumours (i.e. malignant gliomas, lymphomas, metatstases etc.) – be obtained close before the procedure. Thus, frequently two MR series are available prior to biopsy (one leading to suspected diagnosis followed by one serving stereotactic planning). Aim of the presented study was evaluate the growth dynamic of patients with glioblastoma multiforme (GBM) and investigate potential correlations with epidemiological and tumor related features.
Method: For this single-centre retrospective evaluation (2010-2014) all patients with histologically proven GBM diagnosed by stereotactic biopsy with two pre-operative MR series were identified. Volume of contrast enhancing tumour was outlined on T1w MR using Osirix Dicom Viewer®. Tumor growth rate was calculated as the percentage of volume change per day (deltaVol%/d) and correlated with age, size of contrast enhancing Tumor, MGMT and IDH status by using Mann-Whitney-U test.
Results: 84 patients (f=34; m=50, median age 64 ± 12 years ) were included. The median time span between MR imaging was 9.4 ± 7.7 days. Median tumor growth rate was 5.7 ± 6.6 deltaVol%/d. Volume of contrast enhancing tumour less than 20ml in size had a significantly (p<0.0001) higher growth rate. Additionally, there was a significantly slower tumor growth rate in patients over 70 years (7,5 vs. 2,8 Δ Vol%/d). Nor MGMT neither IDH status showed any correlation with tumor growth dynamic.
Conclusions: These findings may suggest, that the growth dynamic of untreated GBM is related to size of the contrast enhancing aspect of the GBM and to patient's age, while molecular features do not show any influence. These findings are supported with the so called Gompertz function describing tumor growth as association between proliferation rate and tumor size over time. How far these results might impact the management of patients with untreated GBM deserves further evaluation in a larger patient population.
