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Prognostic paradox: brain damage around the glioblastoma resection cavity

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Abstract

Hyperintense lesions around the resection cavity on magnetic resonance diffusion-weighted imaging (MR-DWI) frequently appear after brain tumor surgery due to the damage of surrounding brain. The putative connection between the lesion and the prognosis for patients with glioblastoma (GBM) was explored. This retrospective study reviewed consecutive sixty-one patients with newly diagnosed GBM. Postoperative MRI was performed within 2 weeks after the initial surgery. We classified the cases into two groups depending on whether DWI hyperintense lesions were observed or not [DWI(+) group and DWI(−) group]. Progression-free survival (PFS) and overall survival (OS) were compared between the two groups. Forty-two patients were identified. The various extents of hyperintense lesions around the resection cavity were observed in 28/42 (66.7 %) cases. In the DWI(+) and DWI(−) groups, median PFS was 10.0 [95 % confidence interval (CI) 8.4–11.5] and 6.7 (95 % CI 4.9–8.5) months, respectively (p = 0.042), and median OS was 18.0 (95 % CI 12.2–23.8) and 17.0 (95 % CI 15.7–18.3) months, respectively (p = 0.254). On multivariate analysis, the presence of DWI hyperintense lesion was more likely to be an independent predictor for 6-month PFS (p = 0.019; HR, 0.038; 95 % CI 0.002–0.582). Tumor recurrence appeared outside the former DWI hyperintense lesion. Hyperintense lesions surrounding the resected GBM on MR-DWI might be a favorable prognostic factor in patients with GBM.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Neuroscience, Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan

    Takuya Furuta, Mitsutoshi Nakada, Yutaka Hayashi & Jun-ichiro Hamada

  2. Division of Cardiovascular Medicine, Department of Radiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan

    Fumiaki Ueda

  3. Department of Neurosurgery, Noto General Hospital, Nanao, Japan

    Takuya Watanabe & Masaaki Hashimoto

  4. Department of Neurosurgery, Joetsu General Hospital, Joetsu, Japan

    Yasuaki Arakawa

  5. Department of Neurosurgery, Komatsu Municipal Hospital, Komatsu, Japan

    Ryo Higashi & Hisashi Nitta

Authors
  1. Takuya Furuta
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  2. Mitsutoshi Nakada
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  3. Fumiaki Ueda
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  4. Takuya Watanabe
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  5. Yasuaki Arakawa
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  7. Masaaki Hashimoto
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  8. Hisashi Nitta
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  9. Yutaka Hayashi
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  10. Jun-ichiro Hamada
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Correspondence to Mitsutoshi Nakada.

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Furuta, T., Nakada, M., Ueda, F. et al. Prognostic paradox: brain damage around the glioblastoma resection cavity. J Neurooncol 118, 187–192 (2014). https://doi.org/10.1007/s11060-014-1418-1

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  • DOI: https://doi.org/10.1007/s11060-014-1418-1

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