Cystic glioblastoma: An evaluation of IDH1 status and prognosis

J. Manuel Sarmiento, Miriam A Nuno, Alicia Ortega, Debraj Mukherjee, Xuemo Fan, Keith L. Black, Chirag G. Patil

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Controversy exists regarding the prognostic significance of cystic features in newly diagnosed glioblastoma multiforme (GBM) and the pathological origin of cystic GBMs. Objective: To determine whether cystic GBMs develop from low-grade gliomas by evaluating IDH1 status and to evaluate the differences in overall survival between patients with cystic and noncystic tumors. Methods: We retrospectively reviewed the records of 351 consecutive newly diagnosed adult GBM patients treated at our institution from October 1997 to November 2011; patients with >50% cystic tumor composition were further identified. IDH1 mutation was determined by immunohistochemical staining. Patient characteristics and treatment were reported for cystic and noncystic tumors separately. Overall survival was reported for cystic and noncystic cohorts by using the Kaplan-Meier estimates. Results: Of 351 patients, 27 (7.7%) had cystic tumors and 324 (92.3%) had noncystic tumors. Tumor samples for patients with cystic GBMs were immunohistochemically analyzed for IDH1 mutations. Two (7.4%) of the 27 tumor samples were documented as having IDH1 mutations. Characteristics such as age, sex, perioperative Karnofsky Performance Status, tumor size, extent of resection, postsurgery radiation, and temozolomide therapy were comparable in the and noncystic cohorts. Patients in the cystic cohort had a median overall survival of 15.0 months compared with 18.2 months for the noncystic cohort (log-rank P = .77). Conclusion: The low frequency of IDH1 mutation status in our cystic cohort strongly suggests that most newly diagnosed cystic GBMs do not arise from malignant transformation of previously undiagnosed low-grade gliomas. Furthermore, there is no difference in overall survival between patients newly diagnosed with cystic and noncystic GBMs.

Original languageEnglish (US)
Pages (from-to)71-75
Number of pages5
JournalNeurosurgery
Volume74
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Glioblastoma
Neoplasms
Survival
temozolomide
Glioma
Mutation
Karnofsky Performance Status
Kaplan-Meier Estimate
Mutation Rate
Radiotherapy
Staining and Labeling

Keywords

  • Cystic glioblastoma
  • IDH1
  • Low-grade glioma
  • Overall survival

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Manuel Sarmiento, J., Nuno, M. A., Ortega, A., Mukherjee, D., Fan, X., Black, K. L., & Patil, C. G. (2014). Cystic glioblastoma: An evaluation of IDH1 status and prognosis. Neurosurgery, 74(1), 71-75. https://doi.org/10.1227/NEU.0000000000000200

Cystic glioblastoma : An evaluation of IDH1 status and prognosis. / Manuel Sarmiento, J.; Nuno, Miriam A; Ortega, Alicia; Mukherjee, Debraj; Fan, Xuemo; Black, Keith L.; Patil, Chirag G.

In: Neurosurgery, Vol. 74, No. 1, 01.01.2014, p. 71-75.

Research output: Contribution to journalArticle

Manuel Sarmiento, J, Nuno, MA, Ortega, A, Mukherjee, D, Fan, X, Black, KL & Patil, CG 2014, 'Cystic glioblastoma: An evaluation of IDH1 status and prognosis', Neurosurgery, vol. 74, no. 1, pp. 71-75. https://doi.org/10.1227/NEU.0000000000000200
Manuel Sarmiento J, Nuno MA, Ortega A, Mukherjee D, Fan X, Black KL et al. Cystic glioblastoma: An evaluation of IDH1 status and prognosis. Neurosurgery. 2014 Jan 1;74(1):71-75. https://doi.org/10.1227/NEU.0000000000000200
Manuel Sarmiento, J. ; Nuno, Miriam A ; Ortega, Alicia ; Mukherjee, Debraj ; Fan, Xuemo ; Black, Keith L. ; Patil, Chirag G. / Cystic glioblastoma : An evaluation of IDH1 status and prognosis. In: Neurosurgery. 2014 ; Vol. 74, No. 1. pp. 71-75.
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title = "Cystic glioblastoma: An evaluation of IDH1 status and prognosis",
abstract = "Background: Controversy exists regarding the prognostic significance of cystic features in newly diagnosed glioblastoma multiforme (GBM) and the pathological origin of cystic GBMs. Objective: To determine whether cystic GBMs develop from low-grade gliomas by evaluating IDH1 status and to evaluate the differences in overall survival between patients with cystic and noncystic tumors. Methods: We retrospectively reviewed the records of 351 consecutive newly diagnosed adult GBM patients treated at our institution from October 1997 to November 2011; patients with >50{\%} cystic tumor composition were further identified. IDH1 mutation was determined by immunohistochemical staining. Patient characteristics and treatment were reported for cystic and noncystic tumors separately. Overall survival was reported for cystic and noncystic cohorts by using the Kaplan-Meier estimates. Results: Of 351 patients, 27 (7.7{\%}) had cystic tumors and 324 (92.3{\%}) had noncystic tumors. Tumor samples for patients with cystic GBMs were immunohistochemically analyzed for IDH1 mutations. Two (7.4{\%}) of the 27 tumor samples were documented as having IDH1 mutations. Characteristics such as age, sex, perioperative Karnofsky Performance Status, tumor size, extent of resection, postsurgery radiation, and temozolomide therapy were comparable in the and noncystic cohorts. Patients in the cystic cohort had a median overall survival of 15.0 months compared with 18.2 months for the noncystic cohort (log-rank P = .77). Conclusion: The low frequency of IDH1 mutation status in our cystic cohort strongly suggests that most newly diagnosed cystic GBMs do not arise from malignant transformation of previously undiagnosed low-grade gliomas. Furthermore, there is no difference in overall survival between patients newly diagnosed with cystic and noncystic GBMs.",
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T1 - Cystic glioblastoma

T2 - An evaluation of IDH1 status and prognosis

AU - Manuel Sarmiento, J.

AU - Nuno, Miriam A

AU - Ortega, Alicia

AU - Mukherjee, Debraj

AU - Fan, Xuemo

AU - Black, Keith L.

AU - Patil, Chirag G.

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N2 - Background: Controversy exists regarding the prognostic significance of cystic features in newly diagnosed glioblastoma multiforme (GBM) and the pathological origin of cystic GBMs. Objective: To determine whether cystic GBMs develop from low-grade gliomas by evaluating IDH1 status and to evaluate the differences in overall survival between patients with cystic and noncystic tumors. Methods: We retrospectively reviewed the records of 351 consecutive newly diagnosed adult GBM patients treated at our institution from October 1997 to November 2011; patients with >50% cystic tumor composition were further identified. IDH1 mutation was determined by immunohistochemical staining. Patient characteristics and treatment were reported for cystic and noncystic tumors separately. Overall survival was reported for cystic and noncystic cohorts by using the Kaplan-Meier estimates. Results: Of 351 patients, 27 (7.7%) had cystic tumors and 324 (92.3%) had noncystic tumors. Tumor samples for patients with cystic GBMs were immunohistochemically analyzed for IDH1 mutations. Two (7.4%) of the 27 tumor samples were documented as having IDH1 mutations. Characteristics such as age, sex, perioperative Karnofsky Performance Status, tumor size, extent of resection, postsurgery radiation, and temozolomide therapy were comparable in the and noncystic cohorts. Patients in the cystic cohort had a median overall survival of 15.0 months compared with 18.2 months for the noncystic cohort (log-rank P = .77). Conclusion: The low frequency of IDH1 mutation status in our cystic cohort strongly suggests that most newly diagnosed cystic GBMs do not arise from malignant transformation of previously undiagnosed low-grade gliomas. Furthermore, there is no difference in overall survival between patients newly diagnosed with cystic and noncystic GBMs.

AB - Background: Controversy exists regarding the prognostic significance of cystic features in newly diagnosed glioblastoma multiforme (GBM) and the pathological origin of cystic GBMs. Objective: To determine whether cystic GBMs develop from low-grade gliomas by evaluating IDH1 status and to evaluate the differences in overall survival between patients with cystic and noncystic tumors. Methods: We retrospectively reviewed the records of 351 consecutive newly diagnosed adult GBM patients treated at our institution from October 1997 to November 2011; patients with >50% cystic tumor composition were further identified. IDH1 mutation was determined by immunohistochemical staining. Patient characteristics and treatment were reported for cystic and noncystic tumors separately. Overall survival was reported for cystic and noncystic cohorts by using the Kaplan-Meier estimates. Results: Of 351 patients, 27 (7.7%) had cystic tumors and 324 (92.3%) had noncystic tumors. Tumor samples for patients with cystic GBMs were immunohistochemically analyzed for IDH1 mutations. Two (7.4%) of the 27 tumor samples were documented as having IDH1 mutations. Characteristics such as age, sex, perioperative Karnofsky Performance Status, tumor size, extent of resection, postsurgery radiation, and temozolomide therapy were comparable in the and noncystic cohorts. Patients in the cystic cohort had a median overall survival of 15.0 months compared with 18.2 months for the noncystic cohort (log-rank P = .77). Conclusion: The low frequency of IDH1 mutation status in our cystic cohort strongly suggests that most newly diagnosed cystic GBMs do not arise from malignant transformation of previously undiagnosed low-grade gliomas. Furthermore, there is no difference in overall survival between patients newly diagnosed with cystic and noncystic GBMs.

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KW - IDH1

KW - Low-grade glioma

KW - Overall survival

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