Long-term survival of glioblastoma multiforme: importance of histopathological reevaluation |
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| Authors: | Jürgen A. Kraus Matthias Wenghoefer Matthias C. Schmidt Andreas von Deimling Ute Berweiler Wolfgang Roggendorf Sabine Diete Knut Dietzmann Bettina Müller Karlheinz Heuser Guido Reifenberger Uwe Schlegel |
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| Affiliation: | (1) Department of Neurology, University of Bonn Medical Center, Sigmund-Freud-Strasse 25, D-53 105 Bonn, Germany, E-mail: uwe.schlegel@uni-bonn.de, Tel.: +49-228-2876848, Fax: +49-228-2875024, DE;(2) Department of Neuropathology, University of Bonn Medical Center, Sigmund-Freud-Strasse 25, University of Bonn, D-53105 Bonn, Germany, DE;(3) Department of Neurosurgery, University of Bonn Medical Center, Sigmund-Freud-Strasse 25, University of Bonn, D-53105 Bonn, Germany, DE;(4) Department of Neuropathology, Humboldt University of Berlin, D-13353 Berlin, Germany, DE;(5) Department of Neurosurgery, University of Würzburg, D-97080 Würzburg, Germany, DE;(6) Department of Neuropathology, University of Würzburg, D-97080 Würzburg, Germany, DE;(7) Department of Neurology, University of Magdeburg, D-39120 Magdeburg, Germany, DE;(8) Department of Neuropathology, University of Magdeburg, D-39120 Magdeburg, Germany, DE;(9) Department of Neurology, Bavaria Clinics, D-01731 Kreischa, Germany, DE;(10) Department of Neurology, University of Kiel, D-24105 Kiel, Germany, DE |
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| Abstract: | The overall prognosis for patients with glioblastoma multiforme is extremely poor. However, a small proportion of patients enjoy prolonged survival. This study investigated retrospectively the extent to which erroneous histopathological classification may contribute to long-term survival of patients initially diagnosed with “glioblastoma multiforme”. We compared two age- and gender-matched patient groups with different postoperative time to tumor progression (TTP), defined as “short-term” for TTP of less than 6 months (n=54) and “long-term” for TTP of more than 12 months (n=52). Histological specimens of the corresponding tumors, all primarily diagnosed as glioblastome multiforme, were reevaluated according to the current World Health Organization (WHO) classification of central nervous system tumors, with the investigators being blinded to clinical outcome. Among the tumors from short-term TTP patients, one tumor (2%) was reclassified as anaplastic oligoastrocytoma (WHO grade III) while the remaining 53 were confirmed as glioblastoma multiforme. In contrast, 13 tumors (25%) from the long-term TTP patients were reclassified, mostly as anaplastic oligodendroglioma (WHO grade III; n=7) or anaplastic oligoastrocytoma (WHO grade III, n=2), respectively. In addition, three were reclassified as anaplastic astrocytoma (WHO grade III), and one was identified as anaplastic pilocytic astrocytoma (WHO grade III). Our data indicate that a sizable proportion of glioblastoma patients with long-term survival actually carry malignant gliomas with oligodendroglial features. The correct histopathological recognition of these tumors has not only progrostic but also therapeutic implications, since oligodendroglial tumors are more likely to respond favorably to chemotherapy. Received: 9 November 1999, Received in revised form: 13 January 2000, Accepted: 3 February 2000 |
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| Keywords: | Glioblastoma multiforme Oligodendroglial differentiation Long-term survival |
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