Preoperative growth dynamics of untreated glioblastoma: Description of an exponential growth type, correlating factors, and association with postoperative survival

Daniel Feucht ^1,2, Patrick Haas ^1,2, Marco Skardelly ^1,3

⁰Center for Neuro-Oncology, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany.

Neuro-Oncology Advances +

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April 29, 2024

View abstract on PubMed

Summary

Slower glioblastoma growth before surgery is linked to longer patient survival. This study analyzed preoperative tumor growth rates to understand their impact on overall survival after treatment.

Area Of Science

Neuro-oncology
Radiology
Surgical Oncology

Background

Glioblastoma (GBM) growth dynamics are poorly understood.
The influence of preoperative tumor growth on patient outcomes remains unclear.

Purpose Of The Study

To investigate the association between preoperative glioblastoma growth dynamics and postoperative survival.
To analyze tumor growth patterns using volumetric analysis of serial MRI scans.

Main Methods

Retrospective analysis of adult patients with newly diagnosed glioblastoma treated surgically (2010-2020).
Volumetric analysis of preoperative MRI scans (≥2 scans, ≥7 days apart) to calculate individual tumor growth rates.
Multivariable Cox regression to assess the association of preoperative growth rates with overall survival (OS).

Main Results

Exponential tumor growth was observed, with a median tumor volume doubling time (VDT) of 31 days and a median specific growth rate (SGR) of 2.2% per day.
Slower preoperative growth (dichotomized by median SGR) was significantly associated with longer OS (log-rank: P=.010).
SGR showed a negative correlation with tumor size (rho=-0.59, P<.001).

Conclusions

Glioblastoma exhibits exponential growth, particularly in smaller lesions, with considerable variability in growth rates.
Slower preoperative tumor growth is an independent predictor of longer overall survival in patients undergoing tumor resection.

Keywords:

MR imaging glioblastoma neurosurgery survival tumor growth rate