title: Tumor Location and Survival Outcomes in Adult Patients with Supratentorial Glioblastoma by Levels of Toll-Like Receptor 9 Expression.
abstract: BACKGROUND
  Toll-like receptor 9 (TLR9) is a key immunotherapy target for glioblastoma (GBM). This study explored the correlation of TLR9 expression with tumor location and survival outcomes in patients with supratentorial GBM.
  
  
  METHODS
  We retrospectively identified 46 patients with supratentorial GBMs and divided them into those with high TLR9 (TRL9High) and low TLR9 (TRL9Low) levels. The 2 groups were compared by patients' ages, sex, preoperative Karnofsky Performance Scale (KPS) score, resection extent, tumor location, progression-free survival (PFS), and overall survival (OS).
  
  
  RESULTS
  The TLR9 expression percentages for the GBM specimens were TRL9High: 72% (33/46) and TRL9Low: 28% (13/46). The 2 groups showed no differences in patient age (P = 0.147) and sex (χ2= 0.002, P = 0.966), preoperative KPS score (χ2= 0.033, P = 0.855), or resection extent (χ2= 2.405, P = 0.121). Location differed significantly, with 85% (11/13) of TRL9Lowtumors in the left hemisphere and 45% (15/33) of TRL9Hightumors on the same side (χ2= 5.82, P = 0.016). The TRL9Lowgroup had a median PFS of 612 days (range, 77-926 days), significantly longer than the TRL9Highgroup (355 days; range, 105-861 days; P = 0.042). Median OS of the TRL9Lowgroup (733 days; range, 163-969 days) was also significantly longer than in the TRL9Highgroup (396 days; range, 135-1024 days; P = 0.020).
  
  
  CONCLUSIONS
  Patients with TRL9Lowsupratentorial GBM tend to have longer survival than those with higher TLR9 expression. Such tumors show a location preference for the left hemisphere.
authors.affiliation: Department of Neurosurgery, Affiliated Brain Hospital, Guangzhou Medical University (Guangzhou Huiai Hospital), Fangcun, Liwan District, Guangdong Province, P. R. China.
authors.forename: Linsen
authors.initials: L
authors.lastname: Mu
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Yongzhi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Hubei Provincal Hospital of Integrated Chinese and Western Medicine, Wuhan, P. R. China.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Pharmacy, Affiliated Brain Hospital, Guangzhou Medical University (Guangzhou Huiai Hospital), Fangcun, Liwan District, Guangdong Province, P. R. China.
authors.forename: Dewei
authors.initials: D
authors.lastname: Shang
authors.affiliation: Department of Neurosurgery, Affiliated Brain Hospital, Guangzhou Medical University (Guangzhou Huiai Hospital), Fangcun, Liwan District, Guangdong Province, P. R. China.
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Tan
authors.affiliation: Department of Neurosurgery, Affiliated Brain Hospital, Guangzhou Medical University (Guangzhou Huiai Hospital), Fangcun, Liwan District, Guangdong Province, P. R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neuroimaging, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China. Electronic address: radiology888@aliyun.com.
authors.forename: Xuzhu
authors.initials: X
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000096:biosynthesis* / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D005909:Glioblastoma / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality; D015996:Survival Rate / Q000639:trends; D051217:Toll-Like Receptor 9 / Q000096:biosynthesis* / Q000235:genetics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; C495371:TLR9 protein, human; D051217:Toll-Like Receptor 9
keywords: Glioblastoma; Overall survival; Progression-free survival; Toll-like receptor 9