Aymeric Amelot1, Christophe Deroulers2, Mathilde Badoual2, Marc Polivka3, Homa Adle-Biassette3, Emmanuel Houdart4, Antoine F Carpentier5, Sebastien Froelich1,6, Emmanuel Mandonnet1,2,6. 1. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Neurochirurgie, Hôpital Lariboisière, Paris, France. 2. IMNC, UMR8165, Orsay, France. 3. Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'Anatomopathologie, Hôpital Lariboisière, Paris, France. 4. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Neuroradiologie, Hôpital Lariboisière, Paris, France. 5. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Neurologie, Hôpital Avicenne, Bobigny, France. 6. Université Paris 7 Diderot, Paris, France.
Abstract
BACKGROUND: Biophysical modeling of glioma is gaining more interest for clinical practice. The most popular model describes aggressivity of tumor cells by two parameters: net proliferation rate (ρ) and propensity to migrate (D). The ratio ρ/D, which can be estimated from a single preoperative magnetic resonance imaging (MRI), characterizes tumor invasiveness profile (high ρ/D: nodular; low ρ/D: diffuse). A recent study reported, from a large series of glioblastoma multiforme (GBM) patients, that gross total resection (GTR) would improve survival only in patients with nodular tumors. OBJECTIVE: To replicate these results, that is to verify that benefit of GTR would be only observed for nodular tumors. METHODS: Between 2005 and 2012, we considered 234 GBM patients with pre- and postoperative MRI. Stereotactic biopsy (BST) was performed in 109 patients. Extent of resection was assessed on postoperative MRI and classified as GTR or partial resection (PR). Invasiveness ρ/D was estimated from the preoperative tumor volumes on T1-Gadolinium-enhanced and fluid-attenuated inversion recovery sequences. RESULTS: We demonstrate that patients with diffuse GBM (low ρ/D), as well as more nodular (mid and high ρ/D) GBM, presented significant survival benefit from GTR over PR/BST ( P < .001). CONCLUSION: Whatever the degree of tumor invasiveness, as estimated from MRI-driven biophysical modeling, GTR improves survival of GBM patients, compared to PR or BST. This conflicting result should motivate further studies.
BACKGROUND: Biophysical modeling of glioma is gaining more interest for clinical practice. The most popular model describes aggressivity of tumor cells by two parameters: net proliferation rate (ρ) and propensity to migrate (D). The ratio ρ/D, which can be estimated from a single preoperative magnetic resonance imaging (MRI), characterizes tumor invasiveness profile (high ρ/D: nodular; low ρ/D: diffuse). A recent study reported, from a large series of glioblastoma multiforme (GBM) patients, that gross total resection (GTR) would improve survival only in patients with nodular tumors. OBJECTIVE: To replicate these results, that is to verify that benefit of GTR would be only observed for nodular tumors. METHODS: Between 2005 and 2012, we considered 234 GBM patients with pre- and postoperative MRI. Stereotactic biopsy (BST) was performed in 109 patients. Extent of resection was assessed on postoperative MRI and classified as GTR or partial resection (PR). Invasiveness ρ/D was estimated from the preoperative tumor volumes on T1-Gadolinium-enhanced and fluid-attenuated inversion recovery sequences. RESULTS: We demonstrate that patients with diffuse GBM (low ρ/D), as well as more nodular (mid and high ρ/D) GBM, presented significant survival benefit from GTR over PR/BST ( P < .001). CONCLUSION: Whatever the degree of tumor invasiveness, as estimated from MRI-driven biophysical modeling, GTR improves survival of GBM patients, compared to PR or BST. This conflicting result should motivate further studies.
Authors: Shashwat Tripathi; Tito Vivas-Buitrago; Ricardo A Domingo; Gaetano De Biase; Desmond Brown; Oluwaseun O Akinduro; Andres Ramos-Fresnedo; Wendy Sherman; Vivek Gupta; Erik H Middlebrooks; David S Sabsevitz; Alyx B Porter; Joon H Uhm; Bernard R Bendok; Ian Parney; Fredric B Meyer; Kaisorn L Chaichana; Kristin R Swanson; Alfredo Quiñones-Hinojosa Journal: J Neurosurg Date: 2021-10-29 Impact factor: 5.408
Authors: M Visser; D M J Müller; R J M van Duijn; M Smits; N Verburg; E J Hendriks; R J A Nabuurs; J C J Bot; R S Eijgelaar; M Witte; M B van Herk; F Barkhof; P C de Witt Hamer; J C de Munck Journal: Neuroimage Clin Date: 2019-02-22 Impact factor: 4.881