Vol 54, No 5 (2020)
Research Paper
Published online: 2020-09-11

open access

Page views 1449
Article views/downloads 552
Get Citation

Connect on Social Media

Connect on Social Media

Does location matter? Characterisation of the anatomic locations, molecular profiles, and clinical features of gliomas

Christopher Mackintosh1, Richard Butterfield2, Nan Zhang2, Julia Lorence3, Piotr Zlomanczuk4, Bernard R. Bendok5, Richard S. Zimmerman5, Kristin Swanson3, Alyx Porter6, Maciej M. Mrugala6
Pubmed: 32914406
Neurol Neurochir Pol 2020;54(5):456-465.

Abstract

Background. Neuroanatomic locations of gliomas may influence clinical presentations, molecular profiles, and patients’ prognoses. Methods. We investigated our institutional cancer registry to include patients with glioma over a 10-year period. Statistical tests were used to compare demographic, genetic, and clinical characteristics among patients with gliomas in different locations. Survival analysis methods were then used to assess associations between location and overall survival in the full cohort, as well as in relevant subgroups. Results. 182 gliomas were identified. Of the tumours confined to a single lobe, there were 51 frontal (28.0%), 50 temporal (27.5%), 22 parietal (12.1%), and seven occipital tumours (3.8%) identified. Tumours affecting the temporal lobe were associated with reduced overall survival when compared to all other tumours (11 months vs. 13 months, log-rank p = 0.0068). In subgroup analyses, this result was significant for males [HR (95%CI) 2.05 (1.30, 3.24), p = 0.002], but not for females [HR (95%CI) 1.12 (0.65, 1.93), p = 0.691]. Out of 82 cases tested for IDH-1, 10 were mutated (5.5%). IDH-1 mutation was present in six frontal, two temporal, one thalamic, and one multifocal tumour. Out of 21 cases tested for 1p19q deletions, 12 were co-deleted, nine of which were frontal lobe tumours. MGMT methylation was assessed in 45 cases; 7/14 frontal tumours and 6/13 temporal tumours were methylated. Conclusion. Our results support the hypothesis that the anatomical locations of gliomas influence patients’ clinical courses. Temporal lobe tumours were associated with poorer survival, though this association appeared to be driven by these patients’ more aggressive tumour profiles and higher risk baseline demographics. Independently, female patients who had temporal lobe tumours fared better than males. Molecular analysis was limited by the low prevalence of genetic testing in the study sample, highlighting the importance of capturing this information for all gliomas. Importance of this study. The specific neuroanatomic location of tumours in the brain is thought to be predictive of treatment options and overall prognosis. Despite evidence for the clinical significance of this information, there is relatively little information available regarding the incidence and prevalence of tumours in the different anatomical regions of the brain. This study has more fully characterised tumour prevalence in different regions of the brain. Additionally, we have analysed how this information may affect tumours’ molecular characteristics, treatment options offered to patients, and patients’ overall survival. This information will be informative both in the clinical setting and in directing future research.

Article available in PDF format

View PDF Download PDF file

References

  1. Pignatti F, van den Bent M, Curran D, et al. European Organization for Research and Treatment of Cancer Brain Tumor Cooperative Group, European Organization for Research and Treatment of Cancer Radiotherapy Cooperative Group. Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol. 2002; 20(8): 2076–2084.
  2. Simpson JR, Horton J, Scott C, et al. Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: results of three consecutive Radiation Therapy Oncology Group (RTOG) clinical trials. Int J Radiat Oncol Biol Phys. 1993; 26(2): 239–244.
  3. Marchel ANAARATDATCAPKAEMAA. Predictors of Class I epilepsy surgery outcome in tumour-related chronic temporal lobe epilepsy in adults. : Vol 532019.
  4. Ładziński KMABB-BAAHAPAAHMAP. Surgical treatment of adult patients with thalamic tumors with the aid of tractography, fMRI, transcranial electrical stimulation and direct electrical stimulation of the subcortical white matter. : Vol 522018.
  5. Mandonnet E, Capelle L, Duffau H, et al. Preferential brain locations of low-grade gliomas. Cancer. 2004; 100(12): 2622–2626.
  6. Jakola AS, Unsgård G, Myrmel KS, et al. Low grade gliomas in eloquent locations - implications for surgical strategy, survival and long term quality of life. PLoS One. 2012; 7(12): e51450.
  7. Tang Q, Lian Y, Yu J, et al. Anatomic mapping of molecular subtypes in diffuse glioma. BMC Neurol. 2017; 17(1): 183.
  8. Larjavaara S, Mäntylä R, Salminen T, et al. Incidence of gliomas by anatomic location. Neuro Oncol. 2007; 9(3): 319–325.
  9. Nizamutdinov D, Stock EM, Dandashi JA, et al. Prognostication of Survival Outcomes in Patients Diagnosed with Glioblastoma. World Neurosurg. 2018; 109: e67–e74.
  10. Kennedy DN, Lange N, Makris N, et al. Gyri of the human neocortex: an MRI-based analysis of volume and variance. Cereb Cortex. 1998; 8(4): 372–384.
  11. Lim DA, Alvarez-Buylla A. The Adult Ventricular-Subventricular Zone (V-SVZ) and Olfactory Bulb (OB) Neurogenesis. Cold Spring Harb Perspect Biol. 2016; 8(5).
  12. Quiñones-Hinojosa A, Sanai N, Gonzalez-Perez O, et al. The human brain subventricular zone: stem cells in this niche and its organization. Neurosurg Clin N Am. 2007; 18(1): 15–20, vii.
  13. Capdevila C, Rodríguez Vázquez L, Martí J. Glioblastoma Multiforme and Adult Neurogenesis in the Ventricular-Subventricular Zone: A Review. J Cell Physiol. 2017; 232(7): 1596–1601.
  14. Sanai N, Alvarez-Buylla A, Berger MS. Neural stem cells and the origin of gliomas. N Engl J Med. 2005; 353(8): 811–822.
  15. Singh S, Dirks PB. Brain tumor stem cells: identification and concepts. Neurosurg Clin N Am. 2007; 18(1): 31–8, viii.
  16. Golmohammadi MG, Blackmore DG, Large B, et al. Comparative analysis of the frequency and distribution of stem and progenitor cells in the adult mouse brain. Stem Cells. 2008; 26(4): 979–987.
  17. Gittleman H, Ostrom QT, Stetson LC, et al. Females have the survival advantage in glioblastoma. Neuro Oncol. 2018; 20(4): 576–577.
  18. Rubin JB, Lagas JS, Broestl L, et al. Sex differences in cancer mechanisms. Biol Sex Differ. 2020; 11(1): 17.
  19. Yang W, Warrington NM, Taylor SJ, et al. Sex differences in GBM revealed by analysis of patient imaging, transcriptome, and survival data. Sci Transl Med. 2019; 11(473).
  20. Cohen AL, Holmen SL, Colman H. IDH1 and IDH2 mutations in gliomas. Curr Neurol Neurosci Rep. 2013; 13(5): 345.