Long-term survival of glioblastoma multiforme: importance of histopathological reevaluation

被引:0
作者
Jürgen A. Kraus
Matthias Wenghoefer
Matthias C. Schmidt
Andreas von Deimling
Ute Berweiler
Wolfgang Roggendorf
Sabine Diete
Knut Dietzmann
Bettina Müller
Karlheinz Heuser
Guido Reifenberger
Uwe Schlegel
机构
[1] Department of Neurology,
[2] University of Bonn Medical Center,undefined
[3] Sigmund-Freud-Strasse 25,undefined
[4] D-53 105 Bonn,undefined
[5] Germany,undefined
[6] E-mail: uwe.schlegel@uni-bonn.de,undefined
[7] Tel.: +49-228-2876848,undefined
[8] Fax: +49-228-2875024,undefined
[9] Department of Neuropathology,undefined
[10] University of Bonn Medical Center,undefined
[11] Sigmund-Freud-Strasse 25,undefined
[12] University of Bonn,undefined
[13] D-53105 Bonn,undefined
[14] Germany,undefined
[15] Department of Neurosurgery,undefined
[16] University of Bonn Medical Center,undefined
[17] Sigmund-Freud-Strasse 25,undefined
[18] University of Bonn,undefined
[19] D-53105 Bonn,undefined
[20] Germany,undefined
[21] Department of Neuropathology,undefined
[22] Humboldt University of Berlin,undefined
[23] D-13353 Berlin,undefined
[24] Germany,undefined
[25] Department of Neurosurgery,undefined
[26] University of Würzburg,undefined
[27] D-97080 Würzburg,undefined
[28] Germany,undefined
[29] Department of Neuropathology,undefined
[30] University of Würzburg,undefined
[31] D-97080 Würzburg,undefined
[32] Germany,undefined
[33] Department of Neurology,undefined
[34] University of Magdeburg,undefined
[35] D-39120 Magdeburg,undefined
[36] Germany,undefined
[37] Department of Neuropathology,undefined
[38] University of Magdeburg,undefined
[39] D-39120 Magdeburg,undefined
[40] Germany,undefined
[41] Department of Neurology,undefined
[42] Bavaria Clinics,undefined
[43] D-01731 Kreischa,undefined
[44] Germany,undefined
[45] Department of Neurology,undefined
[46] University of Kiel,undefined
[47] D-24105 Kiel,undefined
[48] Germany,undefined
来源
Journal of Neurology | 2000年 / 247卷
关键词
Key words Glioblastoma multiforme; Oligodendroglial differentiation; Long-term survival;
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摘要
The overall prognosis for patients with glioblastoma multiforme is extremely poor. However, a small proportion of patients enjoy prolonged survival. This study investigated retrospectively the extent to which erroneous histopathological classification may contribute to long-term survival of patients initially diagnosed with “glioblastoma multiforme”. We compared two age- and gender-matched patient groups with different postoperative time to tumor progression (TTP), defined as “short-term” for TTP of less than 6 months (n=54) and “long-term” for TTP of more than 12 months (n=52). Histological specimens of the corresponding tumors, all primarily diagnosed as glioblastome multiforme, were reevaluated according to the current World Health Organization (WHO) classification of central nervous system tumors, with the investigators being blinded to clinical outcome. Among the tumors from short-term TTP patients, one tumor (2%) was reclassified as anaplastic oligoastrocytoma (WHO grade III) while the remaining 53 were confirmed as glioblastoma multiforme. In contrast, 13 tumors (25%) from the long-term TTP patients were reclassified, mostly as anaplastic oligodendroglioma (WHO grade III; n=7) or anaplastic oligoastrocytoma (WHO grade III, n=2), respectively. In addition, three were reclassified as anaplastic astrocytoma (WHO grade III), and one was identified as anaplastic pilocytic astrocytoma (WHO grade III). Our data indicate that a sizable proportion of glioblastoma patients with long-term survival actually carry malignant gliomas with oligodendroglial features. The correct histopathological recognition of these tumors has not only progrostic but also therapeutic implications, since oligodendroglial tumors are more likely to respond favorably to chemotherapy.
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页码:455 / 460
页数:5
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