한빛사논문
- 조회332
Yae Won Park 1, Geon Jang 2, Si Been Kim 3, Kaeum Choi 4, Kyunghwa Han 1, Na-Young Shin 1, Sung Soo Ahn 1, Jong Hee Chang 5, Se Hoon Kim 6, Seung-Koo Lee 1, Rajan Jain 7,8
1Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea.
2Department of Industrial Engineering, Yonsei University, Seoul, Korea.
3Undergraduate School of Biomedical Engineering, Korea University College of Health Science, Seoul, Korea.
4Department of Statistics and Data Science, Yonsei University, Seoul, Korea.
5Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
6Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
7Department of Radiology, New York University Grossman School of Medicine, 550 1st Ave., New York, NY States, USA.
8Department of Pathology, New York University Grossman School of Medicine, 550 1st Ave., New York, NY States, USA.
Corresponding Author: Sung Soo Ahn
Abstract
Background: The incidence of leptomeningeal metastases (LM) has been reported diversely. This study aimed to investigate the incidence, risk factors, and prognosis of LM in patients with IDH-wildtype glioblastoma.
Methods: A total of 828 patients with IDH-wildtype glioblastoma were enrolled between 2005 and 2022. Baseline preoperative MRI including post-contrast fluid-attenuated inversion recovery (FLAIR) was used for LM diagnosis. Qualitative and quantitative features, including distance between tumor and subventricular zone (SVZ) and tumor volume by automatic segmentation of the lateral ventricles and tumor, were assessed. Logistic analysis of LM development was performed using clinical, molecular, and imaging data. Survival analysis was performed.
Results: The incidence of LM was 11.4%. MGMTp unmethylation (odds ratio [OR] = 1.92, P = 0.014), shorter distance between tumor and SVZ (OR = 0.94, P = 0.010), and larger contrast-enhancing tumor volume (OR = 1.02, P < 0.001) were significantly associated with LM. The overall survival (OS) was significantly shorter in patients with LM than in those without (log-rank test; P < 0.001), with median OS of 12.2 and 18.5 months, respectively. Presence of LM remained an independent prognostic factor for OS in IDH-wildtype glioblastoma (hazard ratio = 1.42, P = 0.011), along with other clinical, molecular, imaging, and surgical prognostic factors.
Conclusion: The incidence of LM is high in patients with IDH-wildtype glioblastoma, and aggressive molecular and imaging factors are correlated with LM development. The prognostic significance of LM based on post-contrast FLAIR imaging suggests acknowledgement of post-contrast FLAIR as a reliable diagnostic tool for clinicians.
논문정보
- Research article
- 2024년 06월 (BRIC 등록일 2024-06-03)
- 국내(교신)+국외 연구진
- 의약학 > 종양의학
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