Prognostic Factors of IDH Wild-Type Glioblastoma After Extensive Surgery - A Multimodal Atlas of Tumor Locations, Recurrences and Management

Q: What was the aim of this retrospective study?

To identify overall survival and patterns of recurrence in IDH wild-type glioblastoma after extensive surgery using multimodal statistical maps.

Q: How were patients selected and how was surgery extent defined?

Adult patients with IDH wild-type glioblastoma treated between 2013 and 2019 were included, with complete or sub-complete resection defined by residual volume <10 mL.

Q: Which factors were associated with overall survival?

Initial tumor location in the corpus callosum was linked to lower OS, and at recurrence KPS >90 and tumor volume <10 mL were associated with higher OS.

Sep 30, 2026

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Glioblastoma remains highly lethal despite complete resection of contrast enhancement, motivating identification of recurrence patterns and survival determinants. This retrospective study evaluates overall survival and spatial recurrence characteristics in adults with IDH wild-type glioblastoma treated with large extent resection (residual volume <10 mL). Clinical and MRI data are segmented and normalized to MNI space to build multimodal statistical maps; OS is analyzed with log-rank tests and Cox models. Results highlight corpus callosum involvement, effects of KPS and tumor volume at recurrence, and localization of 92% of recurrences near the postoperative cavity.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Introduction

Patients and Methods

Results

Conclusions

Article Prognostic Factors of IDH Wild-Type Glioblastoma After Extensive Surgery: A Multimodal Atlas of Tumor Locations, Recurrences and Management Hajar Selhane 1, Tiphaine Obara 2, Guillaume Vogin 3,4,5, René Anxionnat 6,7, Guillaume Gauchotte 8,9,10, Luc Taillandier 1,2, Marie Blonski 1,2 and Fabien Rech 2,11, * Academic Editor: Nicolai E. Savaskan Received: 14 November 2025 Revised: 12 December 2025 Accepted: 20 December 2025 Published: 24 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Université de Lorraine, CHRU-Nancy, Service de Neurologie, F-54000 Nancy, France 2 Université de Lorraine, CNRS, CRAN, F-54000 Nancy, France 3 Centre François Baclesse, B.P 436, L-4005 Esch-sur-Alzette, Luxembourg 4 Luxembourg Institute of Health, Department of Cancer Research, L-1210 Luxembourg, Luxembourg 5 Université de Luxembourg, Faculté des Sciences, de Technologies et de Médecine, L-4364 Esch-Sur-Alzette, Luxembourg 6 CHRU-Nancy, Université de Lorraine, Service de Neuroradiologie, F-54000 Nancy, France 7 Université de Lorraine, IADI, INSERM U1254, F-54000 Nancy, France 8 CHRU-Nancy, Université de Lorraine, Service d’Anatomopathologie, F-54000 Nancy, France 9 Centre de Ressources Biologiques, CHRU-Nancy, F-54000 Nancy, France 10 INSERM U1256, NGERE, F-54500 Nancy, France 11 CHRU-Nancy, Université de Lorraine, Service de Neurochirurgie, F-54000 Nancy, France * Correspondence: [f.rech@chru-nancy.fr](f.rech@chru-nancy.fr) Simple Summary Glioblastoma is one of the most aggressive tumors of the brain despite complete resection of the contrast enhancement. The aim of our retrospective study was to identify the pattern of recurrence after complete resection. We showed that in such a homogeneous group of patients, overall survival might be low according to initial (corpus callosum) and recurrence location (left atrium) . Multifocal recurrences seemed to be correlated with tumor location (corpus callosum, frontal left, and temporal bilateral) whereas relationship between the subventricular zone and overall survival seemed to be more complex and might depend on the extent of resection and tumor location. We also showed that even in complete resection, 92% of recurrence occurred in the vicinity of the postoperative cavity. These findings also suggest identifying new strategies to improve the local control of the disease even after large surgery. Abstract Introduction: Glioblastomas have poor prognosis despite aggressive treatment. Patterns of recurrence and overall survival (OS) can be very different. The population with complete resection having a so-called good prognosis can nevertheless present poor OS. Our purpose was to assess the OS and patterns of recurrence thanks to multimodal statistical maps in glioblastoma with large extent of resection (residue < 10 mL) . Methods: adult patients presenting IDH wild-type glioblastoma between 2013 and 2019 were selected. Clinical data and MRI characteristics were collected. Preoperative, postoperative, and recurrence volumes were segmented and normalized in the MNI space to compute statistical maps. Log-rank test and Cox model were used to assess OS and prognosis factors. Results: 60 patients were included. Mean residual volume was 0.89 ± 2 mL. Median OS was 22.3 months (95% CI: (20–35)) . Initial location in the corpus callosum was associated with low OS (317 vs. 783 days, HR = 0.46, p = 0.003) . At recurrence, KPS > 90 and tumor volume < 10 mL were associated with higher OS (p = 0.006 and p = 0.05) . Tumor contact with the SVZ as well as multifocal recurrence did not show any impact on the OS. Conclusions: High OS can be obtained thanks to surgery with residual volume < 10 mL. Invasion of the corpus callosum at diagnosis is associated with a poor prognosis despite a large extent

FAQs

What was the aim of this retrospective study?

To identify overall survival and patterns of recurrence in IDH wild-type glioblastoma after extensive surgery using multimodal statistical maps.

How were patients selected and how was surgery extent defined?

Adult patients with IDH wild-type glioblastoma treated between 2013 and 2019 were included, with complete or sub-complete resection defined by residual volume <10 mL.

Which factors were associated with overall survival?

Initial tumor location in the corpus callosum was linked to lower OS, and at recurrence KPS >90 and tumor volume <10 mL were associated with higher OS.

Sep 30, 2026

Uploaded by Pentious