Background: Recent literature has focused on the effect of glioblastoma contact with neural stem cells rich zones (i.e., lateral ventricles sub-ventricular zone), and the influence on overall survival, tumor multifocality and distal spreading. The results of these studies are controversial. We therefore sought to address the influence of tumor location, among other imaging and clinical features, with our glioblastoma patient`s survival. Here, we present a retrospective data analysis of glioblastoma patients` cohort, treated in Soroka University Medical Center in the last decade. All patients included in this work were diagnosed with glioblastoma before 70 years of age and received multimodality treatment which includes tumor resection surgery, radiotherapy, with/without concomitant adjuvant chemotherapy. Data collection and analysis was done for selected clinical and imaging parameters and correlated with patient`s survival.
Methods: Retrospective cohort including 56 GBM patients diagnosed between 2006-2015. Cranial neuronavigation software was used in order to get an accurate approximation of the tumors’ volume. We analyzed all available pre-op MRI (N = 52) and assessed:
1. Multifocality
2. Tumor and edema volume
3. Tumor and edema contact with the subventricular zone (SVZ) and cortex: Tumors (pre-op) were classified into four groups according to their anatomical contact with the SVZ (lateral wall of the lateral ventricle) and cortex.
Results: Tumors and edema with SVZ contact did not have statistically significant effect on survival, but were found to have larger tumor and peritumoral edema volumes at diagnosis. Comparing overall survival (OS) of all patients with edema SVZ involvement revealed that patients with tumor SVZ contact had lower OS than patients without tumor SVZ contact.
Conclusions: Tumor and peritumoral edema relation to the SVZ were not found to be statistically significant risk factors for OS, but demonstrated characteristics depicting a more invasive and aggressive GBM subtype.
