P17.88 * THE CLINICAL SIGNIFICANCE OF EPENDYMAL ENHANCEMENT AT PRESENTATION IN PATIENTS WITH MALIGNANT GLIOMA: SINGLE CENTER EXPERIENCE

Abstract

INTRODUCTION: Data from trials suggest that GBMs adjacent to the subventricular zone and associated with ependymal enhancement on MRI, have a more aggressive and multifocal phenotype which render the patient to a shorter overall survival (OS). The aim of the current study was to re-assess whether ependymal enhancement is associated with a worse outcome. METHODS: After institutional review board approval, a retrospective review of all patients who were treated for GBM in our institution from 2005 to 2011 was conducted. Only patients in whom the pretreatment MRI was available were included in our study. Data extracted from the medical records included age, date of diagnosis, co-morbidities, performance status at time of the first visit prior to initiating treatment, treatment regimen and time of death. All MRI imaging were blindly reviewed by one of the investigators, and were evaluated for distance from the subventricular zone, ependymal enhancement and pial enhancement. The groups were divided according to ependymal enhancement and data extracted was evaluated for association with survival. RESULTS: Between 2005 and 2011, 230 patients were treated at our center. Sixty five patients were excluded from the study due to insufficient data. Sixty seven patients (40.6%) had evidence of ependymal enhancement on MRI (group A). Seventy patients (42.4%) did not have evidence of enhancement (group B). In 28 patients (17%) the imaging was inconclusive, due to involvement of the temporal horn, therefore defined as group C. Median survival of all groups was 15.3 months (range 13.6 to 16.95). Median survival according to ependymal enhancement was 14 months for group A (range 12 to 16), 15.9 months group B (range 14.28 to 17.65) and 11.7 months for group C (range 6.47 to 16.92 ) (P > 0.05). Age <50 yrs, good performance status, pial enhancement, and gross tumor resection were associated with better survival. CONCLUSIONS: Unlike reported by others, in the current study ependymal enhancement on MRI in patients with GBM was not associated with reduced OS.