title: Decreased survival in glioblastomas is specific to contact with the ventricular-subventricular zone, not subgranular zone or corpus callosum.
abstract: The clinical effect of radiographic contact of glioblastoma (GBM) with neurogenic zones (NZ)-the ventricular-subventricular (VSVZ) and subgranular (SGZ) zones-and the corpus callosum (CC) remains unclear and, in the case of the SGZ, unexplored. We investigated (1) if GBM contact with a NZ correlates with decreased survival; (2) if so, whether this effect is associated with a specific NZ; and (3) if radiographic contact with or invasion of the CC by GBM is associated with decreased survival. We retrospectively identified 207 adult patients who underwent cytoreductive surgery for GBM followed by chemotherapy and/or radiation. Age, preoperative Karnofsky performance status score (KPS), and extent of resection were recorded. Preoperative MRIs were blindly analyzed to calculate tumor volume and assess its contact with VSVZ, SGZ, CC, and cortex. Overall (OS) and progression free (PFS) survivals were calculated and analyzed with multivariate Cox analyses. Among the 207 patients, 111 had GBM contacting VSVZ (VSVZ+GBMs), 23 had SGZ+GBMs, 52 had CC+GBMs, and 164 had cortex+GBMs. VSVZ+, SGZ+, and CC+ GBMs were significantly larger in size relative to their respective non-contacting controls. Multivariate Cox survival analyses revealed GBM contact with the VSVZ, but not SGZ, CC, or cortex, as an independent predictor of lower OS, PFS, and early recurrence. We hypothesize that the VSVZ niche has unique properties that contribute to GBM pathobiology in adults.
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, T-4224 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232-2380, USA. axitamm@gmail.com.
authors.forename: Akshitkumar M
authors.initials: AM
authors.lastname: Mistry
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, T-4224 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232-2380, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Dewan
authors.affiliation: School of Medicine, Vanderbilt University, Nashville, TN, USA.
authors.forename: Gabrielle A
authors.initials: GA
authors.lastname: White-Dzuro
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, T-4224 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232-2380, USA.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Brinson
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, T-4224 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232-2380, USA.
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Weaver
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, T-4224 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232-2380, USA.
authors.forename: Reid C
authors.initials: RC
authors.lastname: Thompson
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, T-4224 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232-2380, USA.|Department of Cancer Biology, Vanderbilt University, Nashville, TN, USA.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Ihrie
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, T-4224 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232-2380, USA.
authors.forename: Lola B
authors.initials: LB
authors.lastname: Chambless
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality* / Q000473:pathology*; D003337:Corpus Callosum / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005909:Glioblastoma / Q000401:mortality* / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D017567:Karnofsky Performance Status; D020547:Lateral Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Glioblastoma; Stem cells; Subgranular zone; Subventricular zone; Survival; Ventricular-subventricular zone