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Pathologic diagnosis of recurrent glioblastoma: morphologic, immunohistochemical, and molecular analysis of 20 paired cases

Authors
Kim, JH; Kim, YB; Han, JH; Cho, KG; Kim, SH; Sheen, SS; Lee, HW; Jeong, SY; Kim, BY; Lee, KB
Citation
The American journal of surgical pathology, 36(4):620-628, 2012
Journal Title
The American journal of surgical pathology
ISSN
0147-51851532-0979
Abstract
To evaluate the prognostic value of the volume of residual viable tumor versus therapy-induced necrosis in resection material and the diagnostic value of ancillary tests in recurrent glioblastoma (GBM), we conducted a retrospective review of 20 patients whose initial and recurrent specimens were available. Recurrent GBMs were graded according to the extent of histopathologic parameters: recurrent tumor with high-grade, non-high-grade, and pure high-grade tumor components and therapy-related necrosis. We also examined MIB-1 labeling, isocitrate dehydrogenase 1 mutation, and epidermal growth factor receptor amplification in primary and recurrent GBMs. To evaluate patient outcomes according to clinical and pathologic parameters, a survival analysis was performed, and correlations between histopathologic parameters and each ancillary test were assessed. Among clinical parameters, age above 60 years was associated with decreased survival (P=0.022), but other clinical parameters showed no significant association with overall survival. Among the 3 histopathologic parameters, the extent of recurrent tumor, including high-grade and non-high-grade components, revealed a significant association with overall survival (P=0.042), but neither the extent of pure high-grade components nor therapy-related necrosis showed any prognostic value. MIB-1 labeling, isocitrate dehydrogenase 1 mutation, and epidermal growth factor receptor amplification were useful for the diagnosis of recurrent GBMs but showed no prognostic value. Our data suggest that histopathologic evaluation on the basis of tumor extent in resected recurrent GBM specimens may provide additional prognostic information on the survival of patients with recurrent GBM.
MeSH terms
AdultAgedBrain/metabolism/*pathology/surgeryBrain Neoplasms/*diagnosis/genetics/metabolism/mortalityDNA, Neoplasm/analysisFemaleGlioblastoma/*diagnosis/genetics/metabolism/mortalityHumansIsocitrate Dehydrogenase/genetics/metabolismMaleMiddle AgedNecrosisNeoplasm Recurrence, Local/*diagnosis/surgeryNeoplasm, Residual/*pathologyPrognosisRepublic of Korea/epidemiologyRetrospective StudiesSurvival RateTissue Array AnalysisTumor Markers, Biological/genetics/metabolism
DOI
10.1097/PAS.0b013e318246040c
PMID
22441548
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
Journal Papers > School of Medicine / Graduate School of Medicine > Pulmonary & Critical Care Medicine
Journal Papers > School of Medicine / Graduate School of Medicine > Hematology-Oncology
Journal Papers > School of Medicine / Graduate School of Medicine > Medical Genetics
AJOU Authors
김, 장희김, 영배한, 재호김, 세혁신, 승수이, 현우정, 선용김, 보영이, 기범
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