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Erschienen in: Journal of Neuro-Oncology 1/2013

01.03.2013 | Clinical Study

The incidence and significance of multiple lesions in glioblastoma

verfasst von: Reena P. Thomas, Linda W. Xu, Robert M. Lober, Gordon Li, Seema Nagpal

Erschienen in: Journal of Neuro-Oncology | Ausgabe 1/2013

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Abstract

The location and distribution of glioblastoma (GBM) within the brain parenchyma plays an important role in surgical and radiation planning. Prior studies have reported incidences of multiple lesions at the time of diagnosis ranging from 0.5 to 20 %. Multiple lesions can be further categorized as multifocal (multiple areas involved, but with a clear path of spread from one lesion to another) or multicentric (multiple lesions, no clear path of spread). In this retrospective study, we reviewed our experience with GBM and found the incidence of multiple lesions at time of diagnosis was 35 %, much higher than previously suggested in the literature. Patients with single lesions had an improved overall survival when compared to patients with multiple lesions (18 vs. 10 months). Patients with multicentric lesions fared the worst, with average survival of 3 months. However, the difference between single and multiple lesions (multifocal or multicentric) was no longer significant when taking into consideration age, Karnofsky performance score (KPS) and extent of resection by multivariate analysis. Age, KPS, gross total resection, and MGMT status were independent predictors of outcome. Multiple lesions did not independently confer a worse outcome, but were associated with lower KPS scores and inability to perform gross total resection. These findings suggest that single, multiple and multicentric imaging exams represent a spectrum of presentations of a single disease. The rate of multiple lesions reported here may be the result of improved imaging technology, suggesting that incidence of multiple lesions will continue to increase as imaging technology advances.
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Metadaten
Titel
The incidence and significance of multiple lesions in glioblastoma
verfasst von
Reena P. Thomas
Linda W. Xu
Robert M. Lober
Gordon Li
Seema Nagpal
Publikationsdatum
01.03.2013
Verlag
Springer US
Erschienen in
Journal of Neuro-Oncology / Ausgabe 1/2013
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-012-1030-1

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