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Characterization of Glioblastomas in Young Adults

2006; Wiley; Volume: 16; Issue: 4 Linguagem: Inglês

10.1111/j.1750-3639.2006.00029.x

1750-3639

Bette K. Kleinschmidt‐DeMasters, Lynne Meltesen, Loris McGavran, Kevin O. Lillehei,

Protein Degradation and Inhibitors

Most adult glioblastoma multiformes (GBMs) present in patients 45–70 years old; tumors occurring at the extremes of the adult age spectrum are uncommon, and seldom studied. We hypothesized that young‐adult GBMs would differ from elderly‐adult and from pediatric GBMs. Cases were identified from years 1997 to 2005. Demographic and histological features, MIB‐1 and TP53 immunohistochemical findings and epidermal growth factor receptor (EGFR) amplification status by fluorescence in situ hybridization were compiled and correlated with survival. Twenty‐eight (74%) of our 38 young‐adult GBM patients had primary de novo tumors, two of which occurred in patients with cancer syndromes. Two additional GBMs were radiation‐induced and eight (21%) were secondary GBMs. Seven patients were identified as long‐term (>3 years) survivors. Six of 38 cases manifested unusual morphological features, including three epithelioid GBMs, one rhabdoid GBM, one gliosarcoma and one small cell GBM containing abundant, refractile, eosinophilic inclusions. MIB‐1 index emerged as the most important prognosticator of survival ( P < 0.005). Although there was a trend between extent of necrosis, TP53 immunohistochemical expression, and EGFR amplification status and survival, none reached statistical significance. GBMs in young adults are a more inhomogeneous tumor group than GBMs occurring in older adult patients and show features that overlap with both pediatric and adult GBMs.