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J Neurol Surg A Cent Eur Neurosurg
DOI: 10.1055/a-2479-9978
Review Article

Risk Factors for and Molecular Pathology Characteristics of Systemic Metastasis of Adult Cerebral Glioblastoma: A Pooled Individual Patient Data Analysis and Systematic Review

Lingcheng Zeng
1   Department of Neurosurgery, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, Hubei, People's Republic of China
,
Hongkuan Yang
1   Department of Neurosurgery, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, Hubei, People's Republic of China
,
Hua Li
1   Department of Neurosurgery, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, Hubei, People's Republic of China
,
Rudong Chen
1   Department of Neurosurgery, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, Hubei, People's Republic of China
,
Jian Chen
1   Department of Neurosurgery, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, Hubei, People's Republic of China
,
Jiasheng Yu
1   Department of Neurosurgery, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, Hubei, People's Republic of China
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Abstract

Objective The risk factors for and molecular mechanisms of systemic metastasis of cerebral glioblastoma (GBM) remain to be evaluated.

Patients and Methods Literature about adult GBM patients with systemic metastasis published before December 31, 2022, was searched in “PubMed” and “Web of Science,” and the patient's clinical data were collected and compared with those of patients without metastasis to evaluate the risk factors. The molecular pathology results were summarized to evaluate the mechanism.

Results One hundred and forty-seven patients with metastasis in 113 papers published from 1928 to 2022 were included. Two hundred and forty-nine patients without metastasis who underwent surgery in our department in 2017 were included. Comparison of the two groups showed that age ≤40 years was significantly correlated with metastasis (hazard ratio [HR]: 2.086, 95% CI: 1.124–3.871, p = 0.020) and better overall survival (HR: 1.493, 95% CI: 1.067–2.083, p = 0.019). Molecular pathology results were reported in 39 cases (39/147, 26.5%). The genetic results showed obvious heterogeneity. According to the frequency and positive ratio, IDH-wild type (positive rate 27/30), TERT promoter mutation (11/13), PTEN mutation (10/11), TP53 mutation (10/13), and RB1 mutation (8/9) were common gene changes.

Conclusion In young adult GBM patients, especially those ≤40 years of age with long survival, attention should be given to the development of systemic metastases. Metastasis can be the result of multiclonal gene mutations, in which proliferation- and invasion-related gene changes, such as oncogene or tumor suppressor gene mutations and epithelial–mesenchymal transition-related genes, may play an important role in metastasis.

Keywords

glioblastoma - systemic metastasis - risk factors - molecular pathology


Publication History

Received: 04 February 2024

Accepted: 20 November 2024

Accepted Manuscript online:
21 November 2024

Article published online:
26 May 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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