Relationship of glioblastoma multiforme to the lateral ventricles predicts survival following tumor resection.
OBJECTIVE
There has been an increased focus on the region adjacent to the lateral ventricles (LV) as a potential source of malignant tumors and/or more aggressive disease. We set out to determine if glioblastoma multiforme (GBM) bordering the LV was associated with decreased survival as compared to non-LV GBM.


METHODS
We reviewed the clinical records of 69 consecutive patients undergoing craniotomy for GBM at a single academic institution. Twenty-six patients were identified with contrast-enhancing lesions (CEL) bordering the LV (LV CEL). These 26 patients were matched with 26 patients with CEL not bordering the LV (non-LV CEL). These cohorts were matched for factors consistently shown to be associated with survival, which were age, tumor size, Karnofsky performance score, extent of resection, Gliadel implantation, and Temodar chemotherapy. Overall survival was compared between the cohorts via Log-rank analysis.


RESULTS
Despite similarities in pre-operative clinical status, tumor size, peri-operative outcome, and treatment regimens, the median survival for patients with LV CEL was significantly decreased as compared to patients with non-LV CEL (8 months vs. 11 months), P = 0.02. Additionally, survival analysis in patients stratified by primary and secondary resection also demonstrated a strong trend towards decreased survival after resection of LV CEL. After primary and secondary resection, patients with LV CEL versus non-LV CEL had a median survival of 11 months vs. 14 months (P = 0.10) and 7 months vs. 10 months (P = 0.11), respectively.


CONCLUSIONS
While the causal factors underlying this observation are not provided with this observational study, GBM bordering the LV may carry a prognostic significance.
Chaichana
Kaisorn L
KL
Department of Neurosurgery, The Johns Hopkins Hospital, Johns Hopkins School of Medicine, Johns Hopkins University, CRB II, 1550 Orleans Street, Room 247, Baltimore, MD, 21231, USA.
McGirt
Matthew J
MJ
Frazier
James
J
Attenello
Frank
F
Guerrero-Cazares
Hugo
H
Quinones-Hinojosa
Alfredo
A
D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D020547:Lateral Ventricles / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome