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Erschienen in:
08.08.2024 | Research
Comparative analysis of molecular and histological glioblastomas: insights into prognostic variance
verfasst von: Myunghwan Lee, Philipp Karschnia, Yae Won Park, Kaeum Choi, Kyunghwa Han, Seo Hee Choi, Hong In Yoon, Na-Young Shin, Sung Soo Ahn, Joerg-Christian Tonn, Jong Hee Chang, Se Hoon Kim, Seung-Koo Lee
Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2024
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Purpose
Whether molecular glioblastomas (GBMs) identify with a similar dismal prognosis as a “classical” histological GBM is controversial. This study aimed to compare the clinical, molecular, imaging, surgical factors, and prognosis between molecular GBMs and histological GBMs.
Methods
Retrospective chart and imaging review was performed in 983 IDH-wildtype GBM patients (52 molecular GBMs and 931 histological GBMs) from a single institution between 2005 and 2023. Propensity score-matched analysis was additionally performed to adjust for differences in baseline variables between molecular GBMs and histological GBMs.
Results
Molecular GBM patients were substantially younger (58.1 vs. 62.4, P = 0.014) with higher rate of TERTp mutation (84.6% vs. 50.3%, P < 0.001) compared with histological GBM patients. Imaging showed higher incidence of gliomatosis cerebri pattern (32.7% vs. 9.2%, P < 0.001) in molecular GBM compared with histological GBM, which resulted in lesser extent of resection (P < 0.001) in these patients. The survival was significantly better in molecular GBM compared to histological GBM (median OS 30.2 vs. 18.4 months, P = 0.001). The superior outcome was confirmed in propensity score analyses by matching histological GBM to molecular GBM (P < 0.001).
Conclusion
There are distinct clinical, molecular, and imaging differences between molecular GBMs and histological GBMs. Our results suggest that molecular GBMs have a more favorable prognosis than histological GBMs.
