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Tumour growth rate predicts overall survival in patients with recurrent WHO grade 4 glioma.
Pang, Jeffer Hann Wei; Saffari, Seyed Ehsan; Lee, Guan Rong; Yu, Wai-Yung; Lim, Choie Cheio Tchoyoson; Lim, Kheng Choon; Lee, Chia Ching; Koh, Wee Yao; Chia, Wei Tsau David; Chua, Kevin Lee Min; Tham, Chee Kian; Low, Yin Yee Sharon; Ng, Wai Hoe; Low, Chyi Yeu David; Lin, Xuling.
Afiliación
  • Pang JHW; Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, 308433, Singapore, Singapore.
  • Saffari SE; Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, 308433, Singapore, Singapore.
  • Lee GR; Centre of Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
  • Yu WY; Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, 308433, Singapore, Singapore.
  • Lim CCT; Department of Neuroradiology, National Neuroscience Institute, Singapore, Singapore.
  • Lim KC; Department of Neuroradiology, National Neuroscience Institute, Singapore, Singapore.
  • Lee CC; Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore.
  • Koh WY; Division of Radiation Oncology, National University Cancer Institute, Singapore, Singapore.
  • Chia WTD; Division of Radiation Oncology, National University Cancer Institute, Singapore, Singapore.
  • Chua KLM; Division of Radiation Oncology, National University Cancer Institute, Singapore, Singapore.
  • Tham CK; Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore.
  • Low YYS; Department of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
  • Ng WH; Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore.
  • Low CYD; Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore.
  • Lin X; Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore.
BMC Med Imaging ; 24(1): 125, 2024 May 27.
Article en En | MEDLINE | ID: mdl-38802734
ABSTRACT

PURPOSE:

Accurate prognostication may aid in the selection of patients who will benefit from surgery at recurrent WHO grade 4 glioma. This study aimed to evaluate the role of serial tumour volumetric measurements for prognostication at first tumour recurrence.

METHODS:

We retrospectively analyzed patients with histologically-diagnosed WHO grade 4 glioma at initial and at first tumour recurrence at a tertiary hospital between May 2000 and September 2018. We performed auto-segmentation using ITK-SNAP software, followed by manual adjustment to measure serial contrast-enhanced T1W (CE-T1W) and T2W lesional volume changes on all MRI images performed between initial resection and repeat surgery.

RESULTS:

Thirty patients met inclusion criteria; the median overall survival using Kaplan-Meier analysis from second surgery was 10.5 months. Seventeen (56.7%) patients received treatment post second surgery. Univariate cox regression analysis showed that greater rate of increase in lesional volume on CE-T1W (HR = 2.57; 95% CI [1.18, 5.57]; p = 0.02) in the last 2 MRI scans leading up to the second surgery was associated with a higher mortality likelihood. Patients with higher Karnofsky Performance Score (KPS) (HR = 0.97; 95% CI [0.95, 0.99]; p = 0.01) and who received further treatment following second surgery (HR = 0.43; 95% CI [0.19, 0.98]; p = 0.04) were shown to have a better survival.

CONCLUSION:

Higher rate of CE-T1W lesional growth on the last 2 MRI images prior to surgery at recurrence was associated with increase mortality risk. A larger prospective study is required to determine and validate the threshold to distinguish rapidly progressive tumour with poor prognosis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Imagen por Resonancia Magnética / Glioma / Recurrencia Local de Neoplasia Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Med Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Imagen por Resonancia Magnética / Glioma / Recurrencia Local de Neoplasia Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Med Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Reino Unido