Leptomeningeal metastases at recurrence in IDH-wildtype glioblastomas: incidence, risk factors, and prognosis based on postcontrast FLAIR imaging

Yae Won Park; Geon Jang; Si Been Kim; Kyunghwa Han; Na-Young Shin; Sung Soo Ahn; Jong Hee Chang; Se Hoon Kim; Rajan Jain; Seung-Koo Lee

doi:Objectives: To comprehensively investigate the incidence, risk factors, and prognosis of leptomeningeal metastases (LM) diagnosed at recurrence in IDH-wildtype glioblastoma patients.

Materials and methods: A total of 734 IDH-wildtype glioblastoma patients were enrolled between 2005 and 2022. LM at recurrence was diagnosed with MRI including postcontrast FLAIR. Logistic analysis for development of LM at recurrence was performed with clinical, molecular, imaging (including tumor volume and distance to subventricular zone via automatic segmentation), and surgical data including extent of resection and ventricular entry. The overall survival (OS) was compared between patients with and without LM at recurrence.

Results: The incidence of LM at recurrence based on postcontrast FLAIR was 10.8% (79 patients). On multivariable analysis, younger age at diagnosis (odds ratio (OR) = 0.98, p = 0.011) and ventricular entry (OR = 3.15, p < 0.001) were independent predictors of LM at recurrence. However, patients with LM at recurrence showed no significant difference in OS from patients without LM (log-rank test; p = 0.461), with median OS of 18.0 (95% confidence interval (CI) 16.2-19.8) and 18.5 (95% CI 16.4-20.7) months in patients with and without LM at recurrence, respectively.

Conclusion: The incidence of LM at recurrence is relatively high in IDH-wildtype glioblastoma patients. Younger age and ventricular entry during surgery warrant imaging surveillance for LM at recurrence. As LM at recurrence showed no significant OS compromise and larger extent of resection (EOR) is associated with survival benefits, ventricular entry during maximal safe resection may be acceptable.

Key points: Question The incidence, risk factors, and prognosis of leptomeningeal metastases (LM) diagnosed at recurrence in IDH-wildtype glioblastoma patients are currently unknown. Findings LM at recurrence occurred in 10.8% of cases, with younger age and ventricular entry as risk factors, but no significant difference in survival outcomes between groups. Clinical relevance The incidence, risk factors, and prognosis of LM at recurrence were investigated in IDH-wildtype glioblastoma patients with postcontrast FLAIR. Younger age and ventricular entry warrant surveillance of LM at recurrence, while the overall survival is not as discouraging as expected.

YUHSpace

BROWSE

0 1

Cited 0 times in

Leptomeningeal metastases at recurrence in IDH-wildtype glioblastomas: incidence, risk factors, and prognosis based on postcontrast FLAIR imaging

DC Field	Value	Language
dc.contributor.author	김세훈	-
dc.contributor.author	박예원	-
dc.contributor.author	신나영	-
dc.contributor.author	안성수	-
dc.contributor.author	이승구	-
dc.contributor.author	장종희	-
dc.contributor.author	한경화	-
dc.date.accessioned	2025-10-15T01:49:55Z	-
dc.date.available	2025-10-15T01:49:55Z	-
dc.date.issued	2025-08	-
dc.identifier.issn	0938-7994	-
dc.identifier.uri	https://ir.ymlib.yonsei.ac.kr/handle/22282913/207480	-
dc.description.abstract	Glioblastoma ; Leptomeningeal metastases ; Magnetic resonance imaging ; Prognosis ; Risk factors	-
dc.description.statementOfResponsibility	https://link.springer.com/article/10.1007/s00330-025-11447-x	-
dc.language	English	-
dc.publisher	Springer International	-
dc.relation.isPartOf	EUROPEAN RADIOLOGY	-
dc.rights	CC BY-NC-ND 2.0 KR	-
dc.subject.MESH	1	-
dc.title	Leptomeningeal metastases at recurrence in IDH-wildtype glioblastomas: incidence, risk factors, and prognosis based on postcontrast FLAIR imaging	-
dc.type	Article	-
dc.contributor.college	College of Medicine (의과대학)	-
dc.contributor.department	Dept. of Pathology (병리학교실)	-
dc.contributor.googleauthor	Yae Won Park	-
dc.contributor.googleauthor	Geon Jang	-
dc.contributor.googleauthor	Si Been Kim	-
dc.contributor.googleauthor	Kyunghwa Han	-
dc.contributor.googleauthor	Na-Young Shin	-
dc.contributor.googleauthor	Sung Soo Ahn	-
dc.contributor.googleauthor	Jong Hee Chang	-
dc.contributor.googleauthor	Se Hoon Kim	-
dc.contributor.googleauthor	Rajan Jain	-
dc.contributor.googleauthor	Seung-Koo Lee	-
dc.identifier.doi	Objectives: To comprehensively investigate the incidence, risk factors, and prognosis of leptomeningeal metastases (LM) diagnosed at recurrence in IDH-wildtype glioblastoma patients. Materials and methods: A total of 734 IDH-wildtype glioblastoma patients were enrolled between 2005 and 2022. LM at recurrence was diagnosed with MRI including postcontrast FLAIR. Logistic analysis for development of LM at recurrence was performed with clinical, molecular, imaging (including tumor volume and distance to subventricular zone via automatic segmentation), and surgical data including extent of resection and ventricular entry. The overall survival (OS) was compared between patients with and without LM at recurrence. Results: The incidence of LM at recurrence based on postcontrast FLAIR was 10.8% (79 patients). On multivariable analysis, younger age at diagnosis (odds ratio (OR) = 0.98, p = 0.011) and ventricular entry (OR = 3.15, p < 0.001) were independent predictors of LM at recurrence. However, patients with LM at recurrence showed no significant difference in OS from patients without LM (log-rank test; p = 0.461), with median OS of 18.0 (95% confidence interval (CI) 16.2-19.8) and 18.5 (95% CI 16.4-20.7) months in patients with and without LM at recurrence, respectively. Conclusion: The incidence of LM at recurrence is relatively high in IDH-wildtype glioblastoma patients. Younger age and ventricular entry during surgery warrant imaging surveillance for LM at recurrence. As LM at recurrence showed no significant OS compromise and larger extent of resection (EOR) is associated with survival benefits, ventricular entry during maximal safe resection may be acceptable. Key points: Question The incidence, risk factors, and prognosis of leptomeningeal metastases (LM) diagnosed at recurrence in IDH-wildtype glioblastoma patients are currently unknown. Findings LM at recurrence occurred in 10.8% of cases, with younger age and ventricular entry as risk factors, but no significant difference in survival outcomes between groups. Clinical relevance The incidence, risk factors, and prognosis of LM at recurrence were investigated in IDH-wildtype glioblastoma patients with postcontrast FLAIR. Younger age and ventricular entry warrant surveillance of LM at recurrence, while the overall survival is not as discouraging as expected.	-
dc.contributor.localId	A00610	-
dc.contributor.localId	A05330	-
dc.contributor.localId	A02089	-
dc.contributor.localId	A02234	-
dc.contributor.localId	A02912	-
dc.contributor.localId	A03470	-
dc.contributor.localId	A04267	-
dc.relation.journalcode	J00851	-
dc.identifier.eissn	1432-1084	-
dc.identifier.pmid	39966177	-
dc.subject.keyword	Adult	-
dc.subject.keyword	Aged	-
dc.subject.keyword	Brain Neoplasms* / diagnostic imaging	-
dc.subject.keyword	Brain Neoplasms* / genetics	-
dc.subject.keyword	Brain Neoplasms* / pathology	-
dc.subject.keyword	Contrast Media	-
dc.subject.keyword	Female	-
dc.subject.keyword	Glioblastoma* / diagnostic imaging	-
dc.subject.keyword	Glioblastoma* / genetics	-
dc.subject.keyword	Glioblastoma* / pathology	-
dc.subject.keyword	Humans	-
dc.subject.keyword	Incidence	-
dc.subject.keyword	Isocitrate Dehydrogenase / genetics	-
dc.subject.keyword	Magnetic Resonance Imaging* / methods	-
dc.subject.keyword	Male	-
dc.subject.keyword	Meningeal Neoplasms* / diagnostic imaging	-
dc.subject.keyword	Meningeal Neoplasms* / epidemiology	-
dc.subject.keyword	Meningeal Neoplasms* / genetics	-
dc.subject.keyword	Meningeal Neoplasms* / secondary	-
dc.subject.keyword	Middle Aged	-
dc.subject.keyword	Neoplasm Recurrence, Local* / diagnostic imaging	-
dc.subject.keyword	Prognosis	-
dc.subject.keyword	Retrospective Studies	-
dc.subject.keyword	Risk Factors	-
dc.contributor.alternativeName	Kim, Se Hoon	-
dc.contributor.affiliatedAuthor	김세훈	-
dc.contributor.affiliatedAuthor	박예원	-
dc.contributor.affiliatedAuthor	신나영	-
dc.contributor.affiliatedAuthor	안성수	-
dc.contributor.affiliatedAuthor	이승구	-
dc.contributor.affiliatedAuthor	장종희	-
dc.contributor.affiliatedAuthor	한경화	-
dc.citation.volume	35	-
dc.citation.number	8	-
dc.citation.startPage	5099	-
dc.citation.endPage	5109	-
dc.identifier.bibliographicCitation	EUROPEAN RADIOLOGY, Vol.35(8) : 5099-5109, 2025-08	-
dc.identifier.articleno	10.1007/s00330-025-11447-x	-

Appears in Collections:: 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers

Show simple item record Find it @ YMLIB

License

YUHSpace: Leptomeningeal metastases at recurrence in IDH-wildtype glioblastomas: incidence, risk factors, and prognosis based on postcontrast FLAIR imaging

YUHSpace

BROWSE

Browse

Links