Glioblastoma multiforme natural history

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

If left untreated, glioblastoma multiforme may extend into the meninges, ventricular wall, or spinal cord. Common complications of glioblastoma multiforme include herniation, hydrocephalus, systemic illness, brainstem invasion by tumor, neutron-induced cerebral injury, weakness, fatigue, numbness, surgical complications, and coma. Prognosis is generally poor, and the 5-year survival rate of patients with glioblastoma multiforme is less than 10%.

Glioblastoma multiforme usually form in the cerebral white matter, grow quickly, and can become very large before producing symptoms. Less than 10% grow slowly following degeneration of low-grade astrocytoma or anaplastic astrocytoma.
It may extend into the meninges or ventricular wall, leading to high protein content in the cerebrospinal fluid.
The tumor cells carried in the CSF may rarely spread to the spinal cord. However, metastasis of glioblastoma multiforme beyond the central nervous system is rare. About 50% of glioblastoma multiforme are bilateral.
It arises from the cerebrum and may rarely exhibit the classic infiltration across the corpus callosum, producing a butterfly (bilateral) glioma.

Common complications of glioblastoma multiforme include:^[1]

Prognosis is generally poor, and the 5-year survival rate of patients with glioblastoma multiforme is less than 10%.
Negative prognostic factors include:^[2]
- Degree of necrosis
- Degree of enhancement
- Deep location (e.g. thalamus)
With standard treatment (surgery, radiotherapy, and chemotherapy), the median survival is approximately 14 months.^[3]
Removal of 98% or more of the tumor by surgery has been associated with a better prognosis.

↑ Silbergeld DL, Rostomily RC, Alvord EC (1991). “The cause of death in patients with glioblastoma is multifactorial: clinical factors and autopsy findings in 117 cases of supratentorial glioblastoma in adults”. J Neurooncol. 10 (2): 179–85. PMID 1654403.
↑ Prognosis of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma
↑ Stupp R, Mason W, van den Bent M, Weller M, Fisher B, Taphoorn M, Belanger K, Brandes A, Marosi C, Bogdahn U, Curschmann J, Janzer R, Ludwin S, Gorlia T, Allgeier A, Lacombe D, Cairncross J, Eisenhauer E, Mirimanoff R (2005). “Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma”. N Engl J Med. 352 (10): 987–96. PMID 15758009.