دورية أكاديمية
IDH–wild-type glioblastoma cell density and infiltration distribution influence on supramarginal resection and its impact on overall survival: a mathematical model
| العنوان: | IDH–wild-type glioblastoma cell density and infiltration distribution influence on supramarginal resection and its impact on overall survival: a mathematical model |
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| المؤلفون: | Tripathi, Shashwat, Vivas-Buitrago, Tito, Domingo, Ricardo A., De Biase, Gaetano, Brown, Desmond, Akinduro, Oluwaseun O., Ramos-Fresnedo, Andres, Sherman, Wendy, Gupta, Vivek, Middlebrooks, Erik H., Sabsevitz, David S., Porter, Alyx B., Uhm, Joon H., Bendok, Bernard R., Parney, Ian, Meyer, Fredric B., Chaichana, Kaisorn L., Swanson, Kristin R., Quiñones-Hinojosa, Alfredo |
| المساهمون: | Masira |
| المصدر: | https://thejns.org/view/journals/j-neurosurg/136/6/article-p1567.xmlTest. |
| بيانات النشر: | USA |
| سنة النشر: | 2021 |
| المجموعة: | Repositorio UDES (Repositorio Digital de la Universidad de Santander) |
| الوصف: | Digital ; OBJECTIVE Recent studies have proposed resection of the T2 FLAIR hyperintensity beyond the T1 contrast enhancement (supramarginal resection [SMR]) for IDH–wild-type glioblastoma (GBM) to further improve patients’ overall survival (OS). GBMs have significant variability in tumor cell density, distribution, and infiltration. Advanced mathematical models based on patient-specific radiographic features have provided new insights into GBM growth kinetics on two important parameters of tumor aggressiveness: proliferation rate (ρ) and diffusion rate (D). The aim of this study was to investigate OS of patients with IDH–wild-type GBM who underwent SMR based on a mathematical model of cell distribution and infiltration profile (tumor invasiveness profile). METHODS Volumetric measurements were obtained from the selected regions of interest from pre- and postoperative MRI studies of included patients. The tumor invasiveness profile (proliferation/diffusion [ρ/D] ratio) was calculated using the following formula: ρ/D ratio = (4π/3)2/3 × (6.106/[VT21/1 − VT11/1])2, where VT2 and VT1 are the preoperative FLAIR and contrast-enhancing volumes, respectively. Patients were split into subgroups based on their tumor invasiveness profiles. In this analysis, tumors were classified as nodular, moderately diffuse, or highly diffuse. RESULTS A total of 101 patients were included. Tumors were classified as nodular (n = 34), moderately diffuse (n = 34), and highly diffuse (n = 33). On multivariate analysis, increasing SMR had a significant positive correlation with OS for moderately and highly diffuse tumors (HR 0.99, 95% CI 0.98–0.99; p = 0.02; and HR 0.98, 95% CI 0.96–0.99; p = 0.04, respectively). On threshold analysis, OS benefit was seen with SMR from 10% to 29%, 10% to 59%, and 30% to 90%, for nodular, moderately diffuse, and highly diffuse, respectively. CONCLUSIONS The impact of SMR on OS for patients with IDH–wild-type GBM is influenced by the degree of tumor invasiveness. The authors’ results show that increasing SMR is ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1933-0693 0022-3085 |
| العلاقة: | 1575; 1567; 136; Scopus; Journal of Neurosurgery; https://doi.org/10.3171/2021.6.JNS21925Test; https://repositorio.udes.edu.co/handle/001/7377Test |
| DOI: | 10.3171/2021.6.JNS21925 |
| الإتاحة: | https://doi.org/10.3171/2021.6.JNS21925Test https://repositorio.udes.edu.co/handle/001/7377Test |
| حقوق: | © Copyright 1944-2022 Tha Authors, American Association of Neurological Surgeons ; info:eu-repo/semantics/closedAccess ; Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0) ; https://creativecommons.org/licenses/by-nc-nd/4.0Test/ |
| رقم الانضمام: | edsbas.8DBD034F |
| قاعدة البيانات: | BASE |
| تدمد: | 19330693 00223085 |
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| DOI: | 10.3171/2021.6.JNS21925 |