Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1417208
This article is part of the Research Topic Molecular and Immune Influences in the Progression of Gliomas Vol II View all 3 articles

The Peritumoral Edema Index and Related Mechanisms Influence the Prognosis of GBM Patients

Provisionally accepted
Zhansheng Fang Zhansheng Fang Ting Shu Ting Shu Yiqing Shao Yiqing Shao *Pengxiang Luo Pengxiang Luo Li Lin Li Lin Zewei Tu Zewei Tu Xingen Zhu Xingen Zhu Lei Wu Lei Wu
  • Nanchang University, Nanchang, China

The final, formatted version of the article will be published soon.

    Background: Peritumoral brain edema (PTBE) represents a characteristic phenotype of intracranial gliomas. However, there is a lack of consensus regarding the prognosis and mechanism of PTBE. In this study, clinical imaging data, along with publicly available imaging data, were utilized to assess the prognosis of PTBE in glioblastoma (GBM) patients, and the associated mechanisms were preliminarily analyzed.We investigated relevant imaging features, including edema, in GBM patients using ITK-SNAP imaging segmentation software. Risk factors affecting progression-free survival (PFS) and overall survival (OS) were assessed using a Cox proportional hazard regression model. In addition, the impact of PTBE on PFS and OS was analyzed in clinical GBM patients using the Kaplan-Meier survival analysis method, and the results further validated by combining data from The Cancer Imaging Archive (TCIA) and The Cancer Genome Atlas (TCGA). Finally, functional enrichment analysis based on TCIA and TCGA datasets identified several pathways potentially involved in the mechanism of edema formation.Results: This study included a total of 32 clinical GBM patients and 132 GBM patients from public databases. Univariate and multivariate analyses indicated that age and edema index (EI) are independent risk factors for PFS, but not for OS. Kaplan-Meier curves revealed consistent survival analysis results between IE groups among both clinical patients and TCIA and TCGA patients, suggesting a significant effect of PTBE on PFS but not on OS. Furthermore, functional enrichment analysis predicted the involvement of several pathways related mainly to cellular bioenergetics and vasculogenic processes in the mechanism of PTBE formation. While these novel results warrant confirmation in a larger patient cohort, they support good prognostic value for PTBE assessment in GBM.Our results indicate that a low EI positively impacts disease control in GBM patients, but this does not entirely translate into an improvement in OS. Multiple genes, signaling pathways, and biological processes may contribute to the formation of peritumoral edema in GBM through cytotoxic and vascular mechanisms.

    Keywords: Glioblastoma, Peritumoral brain edema, MRI, bioinformatics glioblastoma, bioinformatics, image segmentation

    Received: 14 Apr 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Fang, Shu, Shao, Luo, Lin, Tu, Zhu and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yiqing Shao, Nanchang University, Nanchang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.