Perioperative cerebral ischemia promote infiltrative recurrence in glioblastoma

  • Background: Hypoxia is a key driver for infiltrative growth in experimental gliomas. It has remained elusive whether tumor hypoxia in glioblastoma patients contributes to distant or diffuse recurrences. We therefore investigated the influence of perioperative cerebral ischemia on patterns of progression in glioblastoma patients. Methods: We retrospectively screened MRI scans of 245 patients with newly diagnosed glioblastoma undergoing resection for perioperative ischemia near the resection cavity. 46 showed relevant ischemia nearby the resection cavity. A control cohort without perioperative ischemia was generated by a 1:1 matching using an algorithm based on gender, age and adjuvant treatment. Both cohorts were analyzed for patterns of progression by a blinded neuroradiologist. Results: The percentage of diffuse or distant recurrences at first relapse was significantly higher in the cohort with perioperative ischemia (61.1%) compared to the control cohort (19.4%). The results of the control cohort matched well with historical data. The change in patterns of progression was not associated with a difference in survival. Conclusions: This study reveals an unrecognized association of perioperative cerebral ischemia with distant or diffuse recurrence in glioblastoma. It is the first clinical study supporting the concept that hypoxia is a key driver of infiltrative tumor growth in glioblastoma patients.

Download full text files

Export metadata

Metadaten
Author:Anna-Luisa Thiepold, Sebastian LugerORCiDGND, Marlies WagnerORCiDGND, Natalie FilmannORCiDGND, Michael Wilfried RonellenfitschORCiDGND, Patrick Nikolaus HarterORCiDGND, Anne Kristin Braczynski, Stephan Dützmann, Elke HattingenORCiDGND, Joachim Peter SteinbachORCiDGND, Christian SenftORCiDGND, Johannes RiegerGND, Oliver Bähr
URN:urn:nbn:de:hebis:30:3-505984
DOI:https://doi.org/10.18632/oncotarget.3994
ISSN:1949-2553
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/25966341
Parent Title (English):OncoTarget
Publisher:Impact Journals LLC
Place of publication:[s. l.]
Document Type:Article
Language:English
Year of Completion:2015
Date of first Publication:2015/05/04
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/07/01
Tag:MRI; glioblastoma; hypoxia; patterns of progression; perioperative ischemia
Volume:6
Issue:16
Page Number:8
First Page:14537
Last Page:14544
Note:
All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License.
HeBIS-PPN:450643476
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 3.0