Long-term survivors of glioblastoma: clinical features and molecular analysis.
BACKGROUND
Glioblastoma is a highly lethal neoplasm with a median survival of 12-14 months; only 2-5% of patients survive >3 years.


METHODS
At our institute, patients with glioblastoma are initially treated with maximum tumor resection followed by radiation and the intravenous injection of nimustine hydrochloride (ACNU).


RESULTS
Using this strategy, 18 of 123 (14.6%) patients treated at our hospital survived >3 years; 7 manifested no recurrence, and the other 11 had early recurrence and received additional therapies. To identify factors associated with prolonged survival, we compared these patients with 21 short-term (<1.5 years) glioblastoma survivors. In the long-term survivors, the MGMT promoter methylation was significantly more frequent. The rate of p53 mutation was lower, and the rate of PTEN mutations and the proliferation index were slightly higher in short-term survivors.


CONCLUSIONS
By multivariate analysis, we found that a younger age and MGMT promoter methylation were significant favorable factors in patients with glioblastoma.
Sonoda
Yukihiko
Y
Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai Miyagi 980-8574, Japan. sono@nsg.med.tohoku.ac.jp
Kumabe
Toshihiro
T
Watanabe
Mika
M
Nakazato
Yoichi
Y
Inoue
Tomoo
T
Kanamori
Masayuki
M
Tominaga
Teiji
T
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D024221:Antineoplastic Protocols; D014408:Biomarkers, Tumor / Q000235:genetics*; D001932:Brain Neoplasms / Q000235:genetics / Q000401:mortality* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D019175:DNA Methylation / Q000235:genetics; D015254:DNA Modification Methylases / Q000235:genetics; D045643:DNA Repair Enzymes / Q000235:genetics; D005909:Glioblastoma / Q000235:genetics / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D015376:Nimustine / Q000008:administration & dosage; D011379:Prognosis; D011401:Promoter Regions, Genetic / Q000235:genetics; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D025521:Tumor Suppressor Proteins / Q000235:genetics; D055815:Young Adult
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D025521:Tumor Suppressor Proteins; D015376:Nimustine; D015254:DNA Modification Methylases; C515491:MGMT protein, human; D045643:DNA Repair Enzymes