Giant cell glioblastoma: A glioblastoma subtype with distinct epidemiology and superior prognosis

¹ Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI
² Division of Radiation Oncology, Moses Cone Regional Cancer Center, Greensboro, NC

^* To whom correspondence should be addressed. E-mail: kozak{at}humonc.wisc.com.

	Abstract

Background: Giant cell glioblastoma (GC) is an uncommon subtype of glioblastoma multiforme (GBM). Consequently, the epidemiology, natural history and factors associated with outcome are not well defined.

Methods: Patients diagnosed with GC from 1988 to 2004 were identified in the Surveillance, Epidemiology and End Results (SEER) database. Outcomes were examined with Kaplan-Meier survival analysis and Cox models. For comparison, similar analyses were conducted for patients diagnosed with GBM.

Results: GC was identified in 1% of 16,430 patients diagnosed with either GC or GBM. Compared to GBM, GC showed similar gender and racial distributions. Likewise, tumor size and location were not significantly different between the two histologies. GC tended to occur in younger patients with a median age at diagnosis of 51 years compared to 62 years for GBM. Additionally, patients with GC were more likely to undergo complete resection compared to patients with GBM. For both histologies, young age, tumor size, extent of resection and the use of adjuvant RT were associated with improved survival. Cox modeling suggests the prognosis for GC is significantly superior to GBM (HR = 0.76, 95% CI 0.59-0.97) even after adjustment for factors impacting survival.

Conclusions: GC is an uncommon GBM subtype that tends to occur in younger patients. Prospective data defining optimal treatment for GC are unavailable; however, these retrospective findings suggest resection, as opposed to biopsy only, and adjuvant RT may improve survival. The prognosis of GC is superior to GBM and long-term survival is possible suggesting aggressive therapy is warranted.

Key Words: Giant cell, glioblastoma , radiation, SEER

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